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R766
R766 – Tibial - first surgeon
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
This fee code represents the service provided by the first surgeon during an in-situ saphenous vein arterial bypass to a tibial artery when two vascular surgeons are involved. The second surgeon's services are billed separately using R767. This procedure is not payable with R804 (the single code for when two surgeons perform the procedure).
When to Use
- Use R766 when performing an in-situ saphenous vein arterial bypass to a tibial artery specifically in a two-surgeon team configuration.
- Use this code as the primary surgeon's fee when the second surgeon is simultaneously billing R767 for their role in the same procedure.
Common Pitfalls
- Billing R766 in conjunction with R804 will result in an automatic rejection, as R804 is intended for single-surgeon scenarios only.
- Submitting R766 without the appropriate vascular surgery specialty designation (03 or 17) will lead to claim denial.
- Failing to ensure the second surgeon is billing R767 can trigger audit flags regarding the necessity of the two-surgeon team.
Billing Tips
- Ensure that surgical assistant units are only claimed by one physician, as OHIP restricts assistant billing for R766 to a single provider.
- Apply relevant after-hours premiums (E409, E410) or trauma premiums (E420) to the R766 fee if the procedure meets the specific eligibility criteria for non-elective or trauma-related care.
Provider Fee$0.00
Specialist Fee$1,303.00
Surgical Assistant Fee$125.10
Anaesthetist Fee$263.33
Non-Anaesthetist Fee$263.33
Effective: April 1, 2025
Category
Q. Cardiovascular Surgical Procedures
Subcategory
CARDIOVASCULAR SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Cardiovascular Surgical Procedures
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