R697 – Metatarsal-tarsal fusion
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the fusion of one or more metatarsal-tarsal joints. This service is eligible for payment to the surgeon (suffix A), a surgical assistant (suffix B), and an anaesthesiologist (suffix C). Fee Calculation: - Surgeon (A): The fee is the listed amount in the Schedule of Benefits. - Surgical Assistant (B): The fee is calculated based on 6 base units plus time units, as per . - Anaesthesiologist (C): The fee is calculated based on 6 base units plus time units, as per -. This service also includes all common elements of an insured service as defined in the Schedule of Benefits (-).
When to Use
- Use R697 when performing a formal arthrodesis of one or more tarsometatarsal (Lisfranc) joints for chronic instability or post-traumatic arthritis.
- Select R697 for surgical fusion procedures involving the metatarsal-tarsal articulation where neurovascular exploration or tenolysis is required as part of the exposure.
Common Pitfalls
- Billing R697 in conjunction with other foot/ankle procedures on the same side without checking for global period or procedural bundling restrictions in the Schedule of Benefits.
- Failing to document the specific joints fused, which can lead to audit scrutiny if the claim is flagged for review against the provided fee.
- Attempting to bill for neurovascular exploration or tenolysis as a separate procedure, as these are explicitly included in the R697 fee.
Billing Tips
- Ensure the operative report clearly details the fusion of the metatarsal-tarsal joints to support the R697 claim, especially if multiple joints are involved in a single session.
- If the procedure is performed on an emergency basis after hours, ensure the claim includes the appropriate E-code premium (E409 or E410) to increase the procedural fee by the correct percentage.
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.
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.
R475 is not eligible for payment for treatment of acute (< 6 weeks from injury) ankle and/or subtalar fractures.
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