R695 – Subtalar arthrodesis
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Subtalar arthrodesis is a surgical procedure to fuse the subtalar joint of the foot, listed under the Musculoskeletal System section of the Schedule of Benefits. Per the Schedule, this procedure includes any neurovascular exploration and/or protection and tenolysis when rendered. An additional fee, E511A, may be claimed for the fusion of additional midtarsal joints during the same operative session. This service is not payable on the same day as R696A (Midtarsal arthrodesis, single joint).
When to Use
- Use R695 for the primary fusion of the subtalar joint when performed as an isolated procedure or as the primary component of a complex foot reconstruction.
- Use R695 in conjunction with E511A when the surgical plan necessitates the fusion of the subtalar joint alongside one or more midtarsal joints during the same operative session.
Common Pitfalls
- Do not bill R696 (Midtarsal arthrodesis) on the same day as R695 for the same patient and side, as they are mutually exclusive; use E511A instead for additional midtarsal joints.
- Avoid billing R719 or R475 alongside R695, as these are restricted combinations that will trigger automatic claim rejections.
- Do not attempt to bill separately for neurovascular exploration or tenolysis, as these are explicitly included in the R695 fee and are not separately compensable.
Billing Tips
- Ensure that if you are performing additional midtarsal joint fusions, you append E511A to the claim to capture the flat fee for each additional joint, as this is the only authorized mechanism for multi-joint billing with R695.
- If the procedure is non-elective and performed after hours, verify the exact start time to apply the correct premium (E409A or E410A), as these are mutually exclusive with trauma premiums (E420).
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
R719, R695, R696, and R697 include any neurovascular exploration and/or protection and tenolysis, when rendered.
R696 is not payable in addition to R695 same patient, same side, same day.
R719 or R695 are not payable in addition to R475 same patient, same side, same day.
R719 is not eligible for payment with R695 same patient, same side, same day.
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