What is OHIP billing code R699?

R699 is "Knee arthroscopy set-up, non-degenerative disorders of the knee or acutely locked knee", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R699 pay?

The current OHIP fee for R699 is $97.35, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R699 to OHIP?

R699 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R699 claims against the Schedule of Benefits rules before submission.

What codes are related to R699?

Codes related to R699 in the Schedule of Benefits include R687.

All codes

R699

R699 – Knee arthroscopy set-up, non-degenerative disorders of the knee or acutely locked knee

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

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Knee arthroscopy set-up for non-degenerative disorders of the knee or an acutely locked knee. This service includes, when rendered, synovial biopsy and/or resection or trimming of plica. This code serves as the base fee to which other arthroscopic knee procedures are added. See payment rules for details on billing with other arthroscopic knee procedures and E-add-on codes.

When to Use

Use R699 as the primary base code for diagnostic arthroscopy when the clinical indication is a non-degenerative disorder, such as a symptomatic plica or synovial pathology.
Use R699 for an acutely locked knee where the primary surgical intent is to address mechanical symptoms not related to chronic degenerative joint disease.
Use R699 as the mandatory base fee when performing additional arthroscopic procedures that do not have their own independent set-up fee.

Common Pitfalls

Billing R699 alongside E476 is a common audit trigger; it is only permitted if you explicitly document an intra-articular loose body or a symptomatic loose screw.
Attempting to bill R699 for degenerative knee conditions (e.g., osteoarthritis) is inappropriate, as R699 is specifically restricted to non-degenerative disorders.
Submitting arthroscopic E-add-on codes that are considered inherent components of the primary procedure will result in automatic rejection or recovery.

Billing Tips

Ensure the operative report clearly distinguishes the non-degenerative nature of the pathology to justify the use of R699 over other potential arthroscopic base codes.
When performing multiple procedures, confirm that the secondary codes are not already inclusive of the set-up service provided by R699 to avoid duplicate billing.

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Provider Fee$97.35

Surgical Assistant Fee$75.06

Anaesthetist Fee$108.43

Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

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