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R657
R657 – LeFort III and LeFort I maxillary advancement
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
LeFort III and LeFort I maxillary advancement is a complex craniofacial surgical procedure. The asterisk (*) in the Schedule of Benefits indicates that the fee for this service includes the harvesting and grafting of bone or cartilage grafts, as noted on page .
When to Use
- Use R657 for combined LeFort III and LeFort I maxillary advancement procedures where both levels of osteotomy are performed in the same operative session.
- Use this code when the surgical plan requires significant maxillary repositioning that necessitates both LeFort III and LeFort I components for craniofacial correction.
Common Pitfalls
- Do not bill separately for bone or cartilage harvesting or grafting, as these are explicitly included in the R657 fee per the Schedule of Benefits asterisk.
- Avoid billing R657 in conjunction with R653 or R654, as these individual LeFort procedures are subsumed by the comprehensive nature of the R657 code.
Billing Tips
- If a second surgical assistant is required for this complex procedure, you must submit a formal letter from the surgeon justifying the necessity to the Ministry for manual review and authorization.
Provider Fee$2,334.85
Surgical Assistant Fee$150.12
Anaesthetist Fee$387.25
Non-Anaesthetist Fee$387.25
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
* Includes harvesting and grafting of bone or cartilage grafts.
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