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R543
R543 – Tenotomy of hamstrings - single
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use R543 when performing a simple release of a single hamstring tendon where no lengthening is required, distinguishing it from the more complex R557.
- Use R543 for a single-site tenotomy; if you are performing tenotomies on multiple hamstring tendons during the same operative session, you must bill R562 instead.
Common Pitfalls
- Billing R543 alongside R562 is a common error; R562 is intended to capture multiple tenotomies, and claiming both will result in a rejection for duplicate or overlapping service.
- Confusing R543 with R557 is a frequent audit risk; ensure your operative report clearly specifies a simple tenotomy (cutting) rather than a lengthening procedure, as the latter requires the higher-valued R557.
Billing Tips
- Always verify the number of tendons released before submission, as R543 is strictly for a single tendon; if you release both the medial and lateral hamstrings, you must use R562.
Provider Fee$168.85
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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