R813 – Embolectomy - artery or graft - as sole procedure
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
R813 represents the surgical procedure for an embolectomy, which is the removal of an embolus (a blood clot or other obstruction) from an artery or a vascular graft. This service is designated as a 'sole procedure', meaning it is only payable when it is the only surgical intervention performed during that operative session. This fee code is eligible for surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) claims. The anaesthesia service has 10 base units, and the assistant service has 7 base units. Time units are calculated in addition to base units as described in the Schedule of Benefits.
When to Use
- Use R813 for an isolated arterial embolectomy where no other surgical procedure, such as a bypass or endarterectomy, is performed during the same operative session.
- Use this code for the removal of an embolus from a vascular graft when the graft revision or other complex reconstruction is not required.
Common Pitfalls
- Billing R813 alongside other surgical codes will result in a rejection, as the 'sole procedure' designation strictly prohibits concurrent surgical billing.
- Attempting to bill R813 for an embolectomy performed as part of a larger vascular reconstruction (e.g., bypass) is an audit risk; in such cases, the embolectomy is considered an integral part of the primary procedure and is not separately payable.
Billing Tips
- If the embolectomy is performed as part of a more extensive procedure, ensure you bill the primary procedure code instead, as R813 is exclusively for isolated cases.
Effective: April 1, 2026
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
Listed as 'Embolectomy - artery or graft - as sole procedure'.
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