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R530
R530 – Quadricepsplasty
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Performs a quadricepsplasty of any type. This is a reconstructive surgical procedure on the muscles/tendons of the femur. This service is eligible for surgeon, assistant, and anaesthesia fees. Assistant services are valued at 6 base units, and anaesthesia services at 7 base units, plus applicable time units for both.
When to Use
- Use R530 for formal surgical release of quadriceps contractures or reconstructive lengthening procedures on the extensor mechanism.
- Select R530 when performing a formal quadricepsplasty rather than simple lysis of adhesions or minor soft tissue releases, which may be better captured under more specific arthroscopic or soft tissue codes.
Common Pitfalls
- Billing R530 concurrently with other major knee procedures without verifying if the procedure is considered inclusive under the Schedule of Benefits, risking rejection for unbundling.
- Failure to document the Injury Severity Score (ISS) in the chart when attempting to claim the E420 trauma premium alongside R530, which leads to automatic claim rejection.
Billing Tips
- Ensure the surgical assistant submits R530B using the correct time units, as the unit value increases significantly after the first hour and again after 2.5 hours.
- Apply the age-based surgical premium automatically for patients under 16, as this is a percentage increase on the base R530 fee and does not require a separate add-on code.
Provider Fee$381.40
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
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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