What is OHIP billing code R623?

R623 is "Symes amputation", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R623 pay?

The current OHIP fee for R623 is $285.80, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R623 to OHIP?

R623 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R623 claims against the Schedule of Benefits rules before submission.

What codes are related to R623?

Codes related to R623 in the Schedule of Benefits include R620, E585, R621, R622, R619.

All codes

R623

R623 – Symes amputation

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

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A Symes amputation is a surgical procedure performed on the foot and ankle, involving disarticulation at the ankle joint. The fee for this service is for the surgeon's work. Assistant and anaesthesia services are calculated separately based on basic and time units.

When to Use

Use R623 for a formal Symes amputation involving disarticulation at the ankle joint, distinct from a trans-tibial amputation (R622) or a partial foot amputation (R620/R621).
Use this code when the clinical objective is the removal of the foot at the ankle joint while preserving the heel pad for weight-bearing.

Common Pitfalls

Billing a hospital admission assessment (A933/C933) on the same day as the surgery is a common rejection if a pre-operative assessment was already billed within the preceding 30 days.
Attempting to bill subsequent hospital visits (C122/C123) during the 2-day period immediately preceding the surgery will result in automatic claim rejection.
Failing to document the Injury Severity Score (ISS) when attempting to claim the E420 trauma premium for this procedure will lead to audit recovery.

Billing Tips

Ensure the 'major pre-operative visit' is clearly identified in your billing if you intend to claim a consultation or assessment fee prior to the procedure, as standard admission assessments are restricted.
If performing bilateral procedures or multiple surgeries under the same anaesthetic, ensure the anaesthesia (R623C) and surgical assistant (R623B) units are calculated based on the major procedure only.

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Provider Fee$285.80

Surgical Assistant Fee$75.06

Anaesthetist Fee$108.43

Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

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