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R515
R515 – Congenital dislocation - knee (open)
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the open reduction of a congenital knee dislocation. It is a surgical procedure billable by the surgeon (R515A), assistant (R515B), and anaesthetist (R515C). - Assistant Fee: The fee is calculated based on 6 base units plus time units as per the rules outlined on -. - Anaesthesia Fee: The fee is calculated based on 7 base units plus time units as per the rules outlined on -.
When to Use
- Use R515A specifically for the open surgical reduction of a congenital knee dislocation, distinguishing it from closed manipulation procedures like R255.
- Apply this code when the clinical documentation confirms an open approach is required for the reduction, as opposed to arthroscopic or percutaneous interventions.
Common Pitfalls
- Billing R515A without the appropriate age-based premium when the patient is under 16 years of age, as these are mandatory for pediatric orthopedic procedures.
- Failing to link the correct assistant (R515B) or anaesthetist (R515C) codes, which can lead to payment delays or rejections if the primary procedure code is not correctly referenced.
Billing Tips
- Ensure the start time of the procedure is accurately recorded to determine eligibility for after-hours premiums (E409, E410) or assistant/anaesthesia after-hours multipliers (E400/E401 series).
Provider Fee$559.55
Surgical Assistant Fee$77.46
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72
Effective: April 1, 2026
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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