What is OHIP billing code R727?

R727 is "Tricuspid annuloplasty", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R727 pay?

The current OHIP fee for R727 is $678.80, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R727 to OHIP?

R727 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R727 claims against the Schedule of Benefits rules before submission.

What codes are related to R727?

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

All codes

R727

R727 – Tricuspid annuloplasty

OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits

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Tricuspid annuloplasty is a surgical procedure on the heart's tricuspid valve. As with all insured services, this procedure includes all common elements as described in - of the Schedule. The fee for the surgeon is a set amount, while fees for the surgical assistant (suffix B) and anaesthesiologist (suffix C) are calculated based on a combination of basic units and time units.

When to Use

Use R727 specifically for the surgical repair of the tricuspid valve annulus, typically performed to address tricuspid regurgitation.
Use R727 when the procedure is performed as a standalone intervention or in conjunction with other cardiac procedures, ensuring the primary surgeon claims R727 as the main procedure code.

Common Pitfalls

Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium, which leads to automatic claim rejection.
Incorrectly billing R727 as a secondary procedure when a more comprehensive valve procedure (such as R724 or R725) is performed, as R727 is generally considered inclusive of the primary valve repair work.
Confusing the basic unit calculations for the assistant (18 units) and the anaesthesiologist (20 units), which results in incorrect total fee submissions.

Billing Tips

Always verify if a second surgical assistant is required; R727 allows for a second assistant without prior authorization, provided the necessity is documented in the operative report.
Ensure that after-hours premiums (E409, E410) are only applied to the procedural fee for non-elective cases or elective cases delayed by an emergency, as elective scheduling does not qualify.

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Provider Fee$678.80

Surgical Assistant Fee$225.18

Anaesthetist Fee$309.80

Non-Anaesthetist Fee$309.80

Effective: April 1, 2025

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