What is OHIP billing code R905?

R905 is "Splenectomy - partial or complete", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R905 pay?

The current OHIP fee for R905 is $493.90, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R905 to OHIP?

R905 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R905 claims against the Schedule of Benefits rules before submission.

All codes

R905

R905 – Splenectomy - partial or complete

OHIP Radiology Code — HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES · Schedule of Benefits

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A surgical procedure for the partial or complete removal of the spleen. This procedure is eligible for assistant (B suffix) and anaesthetist (C suffix) services, with fees calculated based on base units plus time units. The base units for both assistant and anaesthetist are 7. An additional premium of 25% is payable on the surgical fee if performed laparoscopically or with laparoscopic assistance (E793).

When to Use

Use R905 for the definitive surgical removal of the spleen, whether performed as a total splenectomy or a partial resection for conditions like hypersplenism or trauma.
Use R905 in conjunction with E793 when the procedure is performed via a laparoscopic approach to capture the 25% fee premium.

Common Pitfalls

Failing to document the Injury Severity Score (ISS) in the medical record when attempting to claim the E420 trauma premium for an emergency splenectomy.
Attempting to bill for a second surgical assistant without prior authorization from a medical consultant, which will result in an automatic rejection of the second assistant's claim.
Incorrectly applying after-hours premiums (E409, E410) to elective, non-urgent splenectomies that were not delayed by an intervening surgical emergency.

Billing Tips

When performing multiple surgical procedures under the same anaesthetic, ensure you only bill the base units for the major procedure (R905) to avoid claim rejection for duplicate base unit billing.
Always verify the patient's age at the time of the procedure to ensure the correct age-based premium (e.g., GP64) is applied to both the surgical fee and the assistant's services.

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Provider Fee$493.90

Surgical Assistant Fee$87.57

Anaesthetist Fee$108.43

Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

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