What is OHIP billing code R799?

R799 is "Ascending aorta repair or excision with graft", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R799 pay?

The current OHIP fee for R799 is $1473.15, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R799 to OHIP?

R799 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R799 claims against the Schedule of Benefits rules before submission.

What codes are related to R799?

Codes related to R799 in the Schedule of Benefits include R800, R801, R803, R802, R817, R877, R890, R891.

All codes

R799

R799 – Ascending aorta repair or excision with graft

OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits

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This code represents the surgical repair or excision of an aneurysm located in the ascending thoracic aorta, with subsequent replacement using a graft. The service includes all necessary steps for the procedure as outlined in the general preamble for surgical services. The service of a second assistant is eligible for payment only with prior authorization, as per general rules in , unless explicitly listed as an exception.

When to Use

Use R799 for the elective or urgent surgical replacement of an ascending thoracic aorta aneurysm with a prosthetic graft.
Use R799 when the primary surgical objective is the excision and graft replacement of the ascending aorta, distinct from procedures involving the aortic arch (R800) or descending thoracic aorta (R801).

Common Pitfalls

Billing R799 alongside other aortic repair codes (like R800 or R801) without clear documentation of separate, distinct anatomical procedures may lead to rejection for unbundling.
Failure to document the Injury Severity Score (ISS) in the medical record when attempting to claim the E420 trauma premium will result in automatic audit recovery.
Assuming a second assistant is automatically covered; unlike some complex cardiovascular procedures, R799 requires prior authorization for a second assistant unless specific exceptions are met.

Billing Tips

If the procedure is performed for a ruptured thoracic aorta aneurysm, ensure E667 is billed as an add-on to R799 to capture the additional complexity fee.
Always verify the exact start time of the procedure to determine if E409 (evenings) or E410 (nights) applies, as these premiums significantly increase the base fee for non-elective cases.

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Provider Fee$1,473.15

Surgical Assistant Fee$225.18

Anaesthetist Fee$309.80

Non-Anaesthetist Fee$309.80

Effective: April 1, 2025

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