What is OHIP billing code R605?

R605 is "Reconstruction and plastic repair of traumatically amputated extremities", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How do I bill R605 to OHIP?

R605 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R605 claims against the Schedule of Benefits rules before submission.

All codes

R605

R605 – Reconstruction and plastic repair of traumatically amputated extremities

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

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Reconstruction and plastic repair of traumatically amputated extremities. This service is identified as 'Independent Consideration (IC)' in the Schedule of Benefits. Claims for such services must be submitted with a supporting letter explaining the amount of the fee claimed, and must include an appropriate operative or consultation report, and a comparison of the scope and difficulty of the procedure in relation to non-IC procedures in the Schedule.

When to Use

Use R605 for complex, multi-tissue reconstruction of a traumatically amputated extremity that lacks a specific, fixed-fee code in the Schedule of Benefits.
Use R605 when the surgical complexity significantly exceeds standard debridement or simple closure codes like R001 or R002, requiring specialized plastic or reconstructive techniques.

Common Pitfalls

Failing to include a detailed comparison to a non-IC procedure will result in an automatic rejection or a significant reduction in the assessed fee.
Submitting R605 without an operative report that explicitly details the time, complexity, and specific tissues reconstructed often leads to claim denial.
Assuming R605 is a catch-all for any amputation repair; it is strictly for reconstructive plastic repair, not for routine amputation revision or simple stump closure.

Billing Tips

When drafting the required supporting letter, benchmark your requested fee against a similar, high-value fixed-fee musculoskeletal procedure to provide the Ministry with a clear reference point for the IC value.
Ensure the operative report clearly distinguishes between the initial trauma management and the specific reconstructive steps that justify the IC status of R605.

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