What is OHIP billing code R943?

R943 is "Revision and/or repair of AV fistula or graft by plication, imbrication, and/or resection, with or without thrombectomy", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R943 pay?

The current OHIP fee for R943 is $400.00, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R943 to OHIP?

R943 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R943 claims against the Schedule of Benefits rules before submission.

What codes are related to R943?

Codes related to R943 in the Schedule of Benefits include R941, R942, R944, R945, R946.

All codes

R943

R943 – Revision and/or repair of AV fistula or graft by plication, imbrication, and/or resection, with or without thrombectomy

OHIP Radiology Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits

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Revision and/or repair of an arterio-venous (AV) fistula or graft by plication, imbrication, and/or resection, with or without thrombectomy. As per , this service includes revision and/or repair of both the venous and arterial components of the AV fistula or graft, when rendered.

When to Use

Use R943 when performing a surgical revision of an AV fistula or graft involving plication, imbrication, or resection to address stenosis or aneurysmal changes.
Use R943 when a thrombectomy is performed in conjunction with the surgical repair or revision of the AV access site.
Use R943 when the procedure requires addressing both the venous and arterial components of the fistula or graft, as these are bundled into this single code.

Common Pitfalls

Do not bill R943 alongside R941, R942, R944, R945, or R946, as only one of these codes is eligible for payment per patient per day.
Avoid attempting to unbundle the repair of the arterial and venous components; the Schedule of Benefits explicitly mandates that these are included in the R943 fee.
Ensure the procedure does not overlap with other vascular access codes, as the restriction applies to any physician, not just the operating surgeon.

Billing Tips

If the procedure is performed non-electively during after-hours periods, apply the appropriate premium (E409 or E410) to the R943 fee to maximize reimbursement.
Since R943 is a surgical procedure, ensure the operative report clearly details the specific techniques used (plication, imbrication, or resection) to support the claim in the event of an audit.

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Provider Fee$400.00

Surgical Assistant Fee$75.06

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

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