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R501
R501 – Cysts of meniscus
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the excision of cysts of the meniscus. Payment for this service is for the surgeon (suffix A). Fees for a surgical assistant (suffix B) and anaesthetist (suffix C) are also payable and calculated based on basic and time units as outlined in the Schedule of Benefits. See - for surgical assistant rules and - for anaesthesiologist rules.
When to Use
- Use R501 for the surgical excision of a symptomatic meniscal cyst where the primary pathology is the cyst itself rather than a generalized meniscal tear.
- Use this code when the procedure is performed as a standalone excision, distinct from a comprehensive meniscectomy (R431) or repair (R434).
Common Pitfalls
- Billing R501 in conjunction with other meniscal procedures (e.g., R431) on the same knee is often flagged as unbundling; ensure the clinical documentation clearly justifies the separate excision of the cyst.
- Failure to document the specific location and size of the cyst can lead to audit rejections, as the Ministry may view the excision as an integral part of a standard arthroscopic meniscectomy.
Billing Tips
- If the procedure is performed arthroscopically, ensure the operative report explicitly describes the cyst excision to support the use of R501 over more generic arthroscopic codes.
- Always verify if the procedure meets the criteria for after-hours premiums (E409/E410) if performed outside standard operating hours, as these are frequently missed for orthopedic surgical cases.
Provider Fee$126.25
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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