R724 – Pulmonary valvotomy
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Pulmonary valvotomy is a surgical procedure listed under the Cardiovascular Surgical Procedures section of the Schedule of Benefits. The fee for the surgeon is a flat rate, while fees for the surgical assistant and anaesthesiologist are calculated based on a combination of basic units and time-based units. Additional premiums may apply based on patient age, time of day, and other clinical factors.
When to Use
- Use R724 for isolated surgical pulmonary valvotomy when no other valve procedures are performed.
- Use R724 in conjunction with other valve codes if multiple valves are addressed, applying the 85% reduction rule for the additional valve(s) as per the multivalvular replacement policy.
Common Pitfalls
- Failing to apply the 85% fee reduction when R724 is performed alongside other valve procedures, which leads to automatic claim adjustments or audit recovery.
- Incorrectly billing R724 for percutaneous balloon pulmonary valvuloplasty, which is a different procedure with its own specific code set.
- Attempting to stack E420 trauma premiums with after-hours premiums (E409/E410), which is explicitly prohibited by the Schedule of Benefits.
Billing Tips
- Ensure the age-based premium (AGE_PREMIUM) is appended to R724, as pediatric patients frequently require this procedure and the premium significantly increases the total procedural value.
- Always document the exact start time of the procedure in the operative report to justify the use of E409 or E410, as these are strictly time-dependent and audited against hospital logs.
Effective: April 1, 2026
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
Multivalvular replacement - the fee will be that for the major valve replaced plus 85% of the fee for the additional valve or valves.
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