What is OHIP billing code R631?

R631 is "Hemipelvectomy - hindquarter", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R631 pay?

The current OHIP fee for R631 is $796.20, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R631 to OHIP?

R631 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R631 claims against the Schedule of Benefits rules before submission.

All codes

R631

R631 – Hemipelvectomy - hindquarter

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

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This surgical procedure, listed as "Hemipelvectomy - hindquarter" in the Schedule of Benefits, involves the radical amputation of the lower limb which includes the removal of the femur, hip joint, and a significant portion of the innominate bone (ilium, ischium, and pubis). This is a major ablative surgery typically performed for malignant tumors or severe trauma.

When to Use

Use R631 for the radical amputation of the lower limb involving the removal of the femur, hip joint, and significant portions of the innominate bone (ilium, ischium, and pubis).
This code is the appropriate choice for major ablative surgeries necessitated by malignant bone tumors or catastrophic trauma involving the pelvic girdle.

Common Pitfalls

Billing R631 without documenting the specific Injury Severity Score (ISS) when attempting to claim the E420 trauma premium.
Attempting to bill for a second surgical assistant without prior authorization from a medical consultant, as R631 is not on the pre-approved list for multiple assistants.
Incorrectly applying after-hours premiums (E409/E410) alongside the E420 trauma premium, as these are mutually exclusive.

Billing Tips

Ensure the surgical assistant bills R631B using the 15-minute time increment structure, as this is specifically tied to the base units of R631.
If the procedure is non-elective and performed after hours, select the highest applicable premium (E410 for nights vs E409 for evenings/weekends) but do not stack them.

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Provider Fee$796.20

Surgical Assistant Fee$125.10

Anaesthetist Fee$232.35

Non-Anaesthetist Fee$232.35

Effective: April 1, 2025

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