What is OHIP billing code R640?

R640 is "Exploration - tendon sheath", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R640 pay?

The current OHIP fee for R640 is $200.90, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill R640 to OHIP?

R640 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R640 claims against the Schedule of Benefits rules before submission.

What codes are related to R640?

Codes related to R640 in the Schedule of Benefits include R556, E599, R565, E055, R572, R560, E053, R557.

All codes

R640

R640 – Exploration - tendon sheath

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

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Exploration of a tendon sheath is a surgical procedure performed on the foot or ankle. This service is eligible for suffixes for the surgeon (A), assistant (B), and anaesthetist (C). The fee for the surgeon is a set amount. Fees for an assistant and anaesthetist are calculated using a unit-based system. - Assistant Fee: Calculated based on 6 basic units (<documentPageId></documentPageId>:) plus time units (<documentPageId></documentPageId>:). - Anaesthetist Fee: Calculated based on 7 basic units (<documentPageId></documentPageId>:) plus time units (<documentPageId></documentPageId>:).

When to Use

Use R640 for the surgical exploration of a tendon sheath in the foot or ankle when no other definitive repair or reconstruction (such as R556 or R572) is performed.
Select R640 when the procedure is limited to the release of adhesions or the inspection of the sheath for pathology without proceeding to a more complex tendon procedure.

Common Pitfalls

Billing R640 in combination with other foot/ankle tendon procedures often triggers a 'major procedure' rule where only the highest-valued code is paid, leading to the rejection of R640.
Failure to document the specific anatomical site and the necessity of the exploration can lead to audit recovery if the service is deemed incidental to a more comprehensive procedure performed at the same time.

Billing Tips

If performing multiple procedures, ensure the major procedure is billed first, as the basic units for the assistant and anaesthetist are dictated by the highest-valued code in the operative session.

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Provider Fee$200.90

Surgical Assistant Fee$77.46

Anaesthetist Fee$111.72

Non-Anaesthetist Fee$111.72

Effective: April 1, 2026

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