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R828
R828 – Ilio-femoral thrombectomy
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
R828 is for an ilio-femoral thrombectomy, a surgical procedure to remove a thrombus (blood clot) from the iliac and/or femoral veins. This procedure may optionally include the ligation (tying off) of the femoral vein. This is billed with suffix A by the surgeon. Assistant and anaesthesia services are billed with suffixes B and C respectively, and are paid based on a combination of basic and time units.
When to Use
- Use R828 for the surgical removal of an acute thrombus from the iliac and/or femoral vein system.
- Use R828 when the procedure includes the ligation of the femoral vein as part of the thrombectomy intervention.
Common Pitfalls
- Do not bill R828 for venous procedures involving the inferior vena cava alone; E657 is strictly an add-on to R828 and cannot be billed as a standalone procedure.
- Avoid billing R828 in conjunction with other vascular reconstruction codes (like R825 or R826) unless the procedures are distinct and performed at separate sites, as this often triggers manual review or rejection.
Billing Tips
- If the procedure is performed concurrently with an inferior vena cava ligation, ensure E657 is included on the same claim to capture the additional $487.25 fee.
- Always verify if the procedure qualifies for after-hours premiums (E409/E410) based on the exact start time of the surgery, as this significantly impacts the total reimbursement for the surgeon.
Provider Fee$446.50
Surgical Assistant Fee$125.10
Anaesthetist Fee$154.90
Non-Anaesthetist Fee$154.90
Effective: April 1, 2025
Category
Q. Cardiovascular Surgical Procedures
Subcategory
CARDIOVASCULAR SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Cardiovascular Surgical Procedures
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