How much does R654 pay?

The current OHIP fee for R654 is $307.15, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill R654 to OHIP?

R654 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R654 claims against the Schedule of Benefits rules before submission.

What codes are related to R654?

Codes related to R654 in the Schedule of Benefits include R655, E973, M400B.

All codes

R654

R654 – Pericranial flap to orbit or face - unilateral

OHIP Musculoskeletal System Surgical Procedures Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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This service is for the unilateral creation and transposition of a pericranial flap to the orbit or face. The pericranium is the membrane covering the outer surface of the skull. • Surgical Fee (`A` Suffix): Flat fee as listed in the Schedule. • Assistant Fee (`B` Suffix): This service does not have a listed assistant basic unit value. As per the rules on , to claim for an assistant, the service must be submitted as M400B and requires authorization by a medical consultant with a letter of explanation from the surgeon. The basic units for this claim are then derived from the anaesthesia value (6 basic units) plus time units as per -. • Anaesthesia Fee (`C` Suffix): Calculated using 6 basic units plus time units as defined in . • Add-on: If this procedure is performed in conjunction with a coronal approach for the main operation, add E973. () • Bilateral Procedure: The bilateral equivalent of this procedure is billed using R655. This service is also eligible for various premiums, including age-based premiums for patients under 16 (), after-hours premiums for non-elective surgery (, , ), and the trauma premium (E420) if applicable criteria are met ().

For surgical assistant services, where no basic unit is listed for the assistant, payment requires authorization by a medical consultant following submission of a letter from the surgeon outlining the reason the assistant was required. The claim must be submitted using fee code M400B.

R655 E973 M400B

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