R559 – Tendon graft - one
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Tendon graft - one
When to Use
- Use R559 for the primary tendon graft procedure when reconstructing a single tendon defect.
- Use R559 in conjunction with E052 when performing multiple tendon grafts during the same operative session.
Common Pitfalls
- Billing R559 as a second assistant procedure without prior authorization from a medical consultant, as it is not on the pre-approved list for second assistants.
- Attempting to bill an admission assessment separately when it does not qualify as the major pre-operative visit where the decision to operate is finalized.
Billing Tips
- Always append E052 for each additional tendon graft performed beyond the first to ensure accurate reimbursement for the total scope of the procedure.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
Medical record must establish that an insured service was provided, the service submitted is the service rendered, and the service was medically necessary.
For services supervised by a Medical Trainee, the medical record must identify the Supervising Physician, the Medical Trainee, the service performed, patient consent, and that the Supervising Physician has reviewed and signed off on the service.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.