What is OHIP billing code R725?

R725 is "Pulmonary valvotomy and infundibular resection", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R725 pay?

The current OHIP fee for R725 is $758.80, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R725 to OHIP?

R725 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R725 claims against the Schedule of Benefits rules before submission.

What codes are related to R725?

Codes related to R725 in the Schedule of Benefits include R724, R772, R726, R727, R731, R728, R729, R730.

All codes

R725

R725 – Pulmonary valvotomy and infundibular resection

OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits

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Pulmonary valvotomy and infundibular resection is a cardiovascular surgical procedure. Payment for this service is structured based on the role of the physician. The surgeon (suffix A) receives a flat fee. The surgical assistant (suffix B) and anaesthesiologist (suffix C) are compensated based on a unit system, which includes base units plus time units. This service is assigned 18 base units for the assistant and 28 base units for the anaesthesiologist.

When to Use

Use R725 for pulmonary valvotomy combined with infundibular resection when addressing pulmonary stenosis.
Use this code as the primary procedure when multiple cardiovascular procedures are performed, as it dictates the base units for the surgical assistant and anaesthesiologist.

Common Pitfalls

Do not bill a second surgical assistant automatically; R725 is not on the pre-approved list, and claims will be rejected without prior authorization and a supporting letter.
Avoid billing R725 with other surgical codes without applying the multiple procedure rule, which limits the assistant and anaesthesiologist to the base units of the major procedure only.

Billing Tips

Ensure the anaesthesiologist correctly calculates total units by adding the 28 base units to the time units and any applicable modifiers like E022C or E017C for patient status.
Apply the appropriate age premium (e.g., AGE_PREMIUM_LT1Y) to the surgeon's fee if the patient meets the specific age criteria, as this is a surgical procedure.

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Provider Fee$758.80

Surgical Assistant Fee$225.18

Anaesthetist Fee$433.72

Non-Anaesthetist Fee$433.72

Effective: April 1, 2025

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