R794 – Femoro-popliteal bypass with prosthetic graft
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Femoro-popliteal bypass with a prosthetic graft is a procedure to restore blood flow to the lower leg by creating a new route for blood around a blocked artery using an artificial tube. The service is listed under Cardiovascular Surgical Procedures on page . The fee for the surgeon (suffix A) is a flat rate. The fees for the surgical assistant (suffix B) and anaesthetist (suffix C) are calculated based on units. - The assistant service (R794B) has 10 base units (). - The anaesthesia service (R794C) has 10 base units (). Time units are added to these base units as per the rules in the General Preamble (see pages and ). A note on page specifies this procedure may be performed "with or without endarterectomy".
When to Use
- Use R794 when performing a femoro-popliteal bypass specifically utilizing a prosthetic graft, regardless of whether an endarterectomy is performed concurrently.
- Select R794 when the procedure is a primary bypass; do not use this code for revisions or thrombectomies of existing grafts, which may fall under different vascular codes.
Common Pitfalls
- Billing R794 alongside R878 is a common rejection trigger, as these are explicitly restricted from being paid on the same patient on the same day.
- Failing to document the specific type of graft used can lead to audit discrepancies, as R794 is strictly for prosthetic grafts rather than autogenous vein grafts.
- Incorrectly assuming an endarterectomy requires a separate code; the fee for R794 is inclusive of any endarterectomy performed during the bypass.
Billing Tips
- Ensure that the surgical assistant (R794B) and anaesthetist (R794C) correctly calculate their total fee by adding time units to the 10 base units as per General Preamble rules.
- If the procedure is non-elective and occurs during after-hours, ensure the appropriate premium (E409/E410 for surgeon, E400/E401 for assistant/anaesthesia) is appended to maximize the claim value.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
The service listing on page notes that R794 can be performed with or without endarterectomy.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.