What is OHIP billing code R552?

R552 is "Revision of arthrodesis", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R552 pay?

The current OHIP fee for R552 is $506.65, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R552 to OHIP?

R552 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R552 claims against the Schedule of Benefits rules before submission.

What codes are related to R552?

Codes related to R552 in the Schedule of Benefits include R466.

All codes

R552

R552 – Revision of arthrodesis

OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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Revision of a previously performed ankle arthrodesis (ankle fusion). This procedure is listed in the Foot and Ankle subsection of Musculoskeletal System Surgical Procedures. The service has 6 base units for a surgical assistant (R552B) and 7 base units for anaesthesia (R552C).

When to Use

Use R552 for the surgical revision of a previously failed ankle arthrodesis, such as in cases of non-union or malunion requiring hardware removal and re-fusion.
Select R552 when performing a salvage procedure on an ankle that has already undergone a primary fusion, as opposed to a primary fusion procedure like R466.

Common Pitfalls

Billing R552 for a primary ankle arthrodesis instead of the appropriate primary fusion code, which will lead to audit scrutiny.
Failing to document the specific 'revision' nature of the procedure, which is essential to justify the higher complexity and fee compared to primary arthrodesis codes.
Attempting to bill R552 alongside other major foot/ankle procedures without clear documentation of separate incisions or distinct clinical indications, risking rejection for unbundling.

Billing Tips

Ensure the operative report explicitly details the previous fusion site and the specific revision steps taken to differentiate it from a primary procedure.
Always confirm the patient's age at the time of the procedure to correctly apply the mandatory age-based percentage premiums (R552A/R552B) if applicable.

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Provider Fee$506.65

Surgical Assistant Fee$75.06

Anaesthetist Fee$108.43

Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

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