What is OHIP billing code R768?

R768 is "Pulmonary artery banding", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R768 pay?

The current OHIP fee for R768 is $628.95, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R768 to OHIP?

R768 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R768 claims against the Schedule of Benefits rules before submission.

What codes are related to R768?

Codes related to R768 in the Schedule of Benefits include R769.

All codes

R768

R768 – Pulmonary artery banding

OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits

Ask AI Bill This Code — Sign Up Free

Pulmonary artery banding is a surgical procedure listed in the Cardiovascular Surgical Procedures section. This service has a surgical fee (A suffix), and separate unit-based fees for surgical assistance (B suffix) and anaesthesia (C suffix). The base units for assistance are 13, and for anaesthesia are 20.

When to Use

Use R768 for the surgical placement of a band around the pulmonary artery to restrict blood flow, typically in infants with congenital heart defects.
Use this code for non-elective, life-saving pulmonary artery banding performed as a palliative measure prior to definitive surgical repair.

Common Pitfalls

Billing R768 in conjunction with other major cardiac procedures without ensuring the 'multiple procedure' rule is applied, which limits the assistant and anaesthesia units to the major procedure only.
Failing to document the Injury Severity Score (ISS) when attempting to claim the E420 trauma premium, which is a common trigger for post-payment audit recovery.
Incorrectly applying after-hours premiums (E409, E410) to elective, scheduled cases that do not meet the 'non-elective' or 'delayed by emergency' criteria.

Billing Tips

Always verify the patient's exact age in days or years at the time of the procedure to ensure the correct percentage-based age premium is applied to the R768 base fee.
When billing for surgical assistance or anaesthesia, ensure the claim reflects the base units (13 for assistance, 20 for anaesthesia) and apply the appropriate E-series premium code only if the case start time strictly meets the defined after-hours windows.

Have a specific question? Ask our billing assistant

Provider Fee$628.95

Surgical Assistant Fee$162.63

Anaesthetist Fee$309.80

Non-Anaesthetist Fee$309.80

Effective: April 1, 2025

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in