R827 – Creation of A.V. fistula
OHIP Radiology Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This code represents a surgical procedure from the Digestive System section of the Schedule of Benefits. The primary fee is for the surgeon performing the procedure. Associated services such as surgical assistance and anaesthesia are also eligible for payment and are calculated based on a system of basic and time units as outlined in the General Preamble. For detailed rules on calculating surgical assistant fees, see -. For detailed rules on calculating anaesthesiologist fees, see -.
When to Use
- Use R827 for the surgical creation of an arteriovenous (AV) fistula for hemodialysis access.
- Use this code for primary fistula construction; do not use it for subsequent revisions or thrombectomies, which require different procedural codes.
Common Pitfalls
- Billing an admission assessment (A933/C933/C003/C004) on the same day as the procedure is prohibited if a pre-operative assessment was already billed within the previous 30 days.
- Attempting to claim this code alongside other surgical procedures without proper consideration of the Multiple Procedure Rule (GP41), which reduces payment for secondary procedures performed during the same operative session.
Billing Tips
- Ensure the operative report clearly details the anatomy of the fistula created to support the R827 claim in the event of a post-payment audit.
- Always append the correct suffix (A for surgeon, B for assistant, C for anaesthesia) to ensure the claim processes against the correct fee schedule and unit calculations.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Surgical
Digestive System Surgical Procedures
Surgical Codes: In the surgical part of the Schedule, the required suffixes are: suffix A if the physician performs the procedure; suffix B if the physician assisted at the surgery; and suffix C if the physician administered the anaesthetic.
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