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Surgical specialties & anaesthesia
Cardiovascular & Thoracic Surgery OHIP billing codes
Cardiac surgery consultations and visits, coronary and valve surgery, aortic surgery, arrhythmia and device procedures, congenital repairs and support devices.
70 codes in 9 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 09 is in the full CV/Thoracic Surgery listing.
Consultations & assessments — office
Hospital in-patient
- C095Consultation - Cardiac Surgery - Non-Emergency Hospital In-Patient—
- C096Repeat consultationRepeat consultation - non-emergency hospital in-patient—
- C093Specific assessmentSpecific assessment - Cardiac Surgery - Hospital In-Patient—
- C094Specific re-assessment—
- C092Subsequent visit - first five weeksSubsequent visit - first five weeks (per visit)—
- C097Subsequent visit - sixth to thirteenth week inclusive—
- C099Subsequent visits - after thirteenth weekRoutine in-hospital subsequent visit by a Cardiac Surgery specialist for an admitted patient, rendered more than 13 weeks after admission. Limited to six visits per month.—
- C098Concurrent careConcurrent care (per visit)—
Coronary surgery
- R742Coronary artery repair - oneSurgical procedure for the repair of one coronary artery, eligible for surgeon (A), assistant (B), and anaesthetist (C) services.$981.85
- E654Coronary artery repair - each additionalAn add-on fee for each additional coronary artery repair performed, subsequent to the primary repairs covered by codes `R742` or `R743`.$188.85
- E652Use of internal mammary, epigastric, or radial artery for bypass graftAn add-on fee for using an internal mammary, epigastric, or radial artery for construction of bypass graft, claimed in addition to coronary artery repair codes R742 or R743.$187.85
- R741Coronary artery endarterectomy and/or gas endarterectomyA surgical procedure involving the excision and removal of plaque (endarterectomy), with or without the use of gas, from a coronary artery to restore blood flow to the heart.$730.70
- E650Cardiopulmonary bypass pump runA cardiovascular surgical procedure for pump bypass, which includes cannulating and decannulating the heart or major vessels, and supervision of the pump and pump run.$400.00
- E679Vein graft harvest remote from site of by-passThis is an add-on fee for harvesting a vein graft from a remote site when the saphenous vein is unavailable, billed in addition to another primary vascular procedure.$124.10
Valve surgery
- R735Mitral replacementA surgical procedure for the replacement of the heart's mitral valve. Fees are specified for the surgeon, with assistant and anaesthesiologist services calculated based on time and base units.$1315.65
- R773Mitral valve reconstruction - simpleA surgical procedure for the simple reconstruction of the mitral valve, which includes annuloplasty for repair of the valve's annulus.$1648.25
- R774Mitral valve reconstruction - complexA complex surgical procedure for mitral valve reconstruction which includes annuloplasty and the repair of both the anterior and posterior leaflets.$2058.20
- R734Mitral annuloplastyA surgical procedure involving the repair of the annulus of the mitral valve, the fibrous ring that supports the mitral valve leaflets.$837.00
- R733Mitral valvuloplastyA surgical procedure to repair the mitral valve of the heart.$963.40
- R729Mitral valvotomyA surgical procedure to widen a stenotic mitral valve by incising the valve's commissures. This code applies to the primary (first-time) procedure.$717.25
- R863Replacement of aortic valve, replacement of ascending aorta, and reimplantation of coronary arteries (Modified Bentall)A complex cardiac surgery for the replacement of the aortic valve, the ascending aorta, and the reimplantation of the coronary arteries, also known as a Modified Bentall procedure. Includes surgeon, assistant, and anaesthesia components.$2153.40
- R876Valve sparing aortic root replacement or remodellingA surgical procedure for valve-sparing aortic root replacement or remodelling.$2230.75
- R930Aortic valvoloplastySurgical repair of the aortic heart valve, a procedure to improve its function.$837.70
- R736Aortic valvotomyA surgical procedure involving the incision of the aortic valve to relieve stenosis.$776.05
- E656Aortic annuloplastyAn add-on service for aortic annuloplasty (reconstruction and enlargement of the aortic annulus), payable in addition to aortic valve replacement (`R732`) and/or patch aortoplasty (`E647`).$288.85
- R727Tricuspid annuloplastyA surgical procedure for the repair of the tricuspid valve's annulus. This service is a major surgical procedure eligible for surgeon, assistant, and anaesthesiologist fees.$678.80
- R728Tricuspid valve replacementA major cardiovascular surgical procedure to replace the tricuspid valve.$777.40
- R731Tricuspid valvuloplastyTricuspid valvuloplasty (`<billingCode>R731</billingCode>`) is the surgical repair of the tricuspid valve. This procedure is eligible for surgeon, assistant, and anaesthesiologist fees.$770.55
- R772Pulmonary valve replacementA surgical procedure for the replacement of the heart's pulmonary valve, billable by the surgeon, assistant, and anaesthesiologist.$758.80
- R724Pulmonary valvotomyA surgical procedure to repair the pulmonary valve of the heart. This procedure is eligible for surgeon, assistant, and anaesthetist fees.$727.00
Aorta
- R799Ascending aorta repair or excision with graftSurgical repair or excision of an ascending thoracic aortic aneurysm with graft placement. This procedure is eligible for assistant and anaesthetist services, calculated by a unit-based system.$1473.15
- R800Aortic arch repair or excision with graftSurgical repair or excision with a graft for an aneurysm located in the arch of the thoracic aorta.$1840.35
- R802Open abdominal aortic repair (tube graft or endarterectomy)A surgical procedure for the repair or excision of an abdominal aortic aneurysm with a graft, which may also include a unilateral common femoral repair.$2031.95
- R803Thoraco-abdominal aneurysm - repair or excision with graftSurgical repair or excision of a thoraco-abdominal aneurysm with a graft, a procedure listed under Cardiovascular Surgical Procedures.$3261.85
- E647Patch aortoplasty with pericardium or graftAn add-on surgical fee for performing a patch aortoplasty with pericardium or a graft. This service is billed in addition to aortic valve replacement (R732) and/or aortic annuloplasty (<billingCode>E656</billingCode>).$264.70
- R758Resection coarctation - adolescent or adultSurgical resection of a coarctation of the aorta for an adolescent or adult patient.$1079.80
Arrhythmia & devices
- R706Right and left atrial ablative procedure for treatment of atrial arrhythmiaA comprehensive surgical procedure for atrial arrhythmia, performed via open surgery or with an energy source, that involves ablating tissue in both the right and left atria. This procedure includes all elements of a left atrial ablation (<billingCode>R709</billingCode>) and adds the necessary right atrial work.$1245.85
- R709Left atrial ablative procedure for surgical treatment of atrial arrhythmiaA surgical procedure for atrial arrhythmia, such as a Cox-Maze procedure or one using an energy source, involving ablation of the left atrium. This includes management of the left atrial appendage and ablation of the pulmonary veins.$778.65
- R710Resection/ablation for ventricular tachycardiaResection/ablation for ventricular tachycardia (to include cardiotomy, mapping with or without HIS bundle)$1112.15
- E658HIS Bundle ablationSurgical add-on procedure for the ablation of the HIS bundle, performed in conjunction with a primary cardiac surgery.$278.10
- E660Epicardial E.P.S. mappingAn add-on surgical procedure for epicardial electrophysiologic study (E.P.S.) mapping, performed in conjunction with another primary cardiac surgical procedure.$185.15
- R752Atrio-ventricular sequential pacemaker with permanent atrial and ventricular endocardial electrodesA cardiovascular surgical procedure for the implantation of an atrio-ventricular sequential pacemaker, including permanent atrial and ventricular endocardial electrodes.$454.55
- R761Implantation of cardioverter defibrillator - by transvenous approachThis surgical procedure involves the implantation of a cardioverter defibrillator (CD) using a transvenous approach.$587.35
Congenital & structural
- R715Closure of atrial septal defect - secundumSurgical closure of a secundum type atrial septal defect. This cardiovascular surgical procedure is eligible for surgeon (A), assistant (B), and anaesthesiologist (C) services.$828.65
- R717Closure of atrial septal defect with anamalous pulmonary venous drainageSurgical procedure for the closure of an atrial septal defect combined with the correction of anomalous pulmonary venous drainage.$948.75
- R718Closure of ventricular septal defectA surgical procedure for the closure of a ventricular septal defect (VSD). This code should only be claimed once, regardless of the number of defects repaired by a single patch.$948.75
- R720Total repair Tetralogy of FallotA major cardiovascular surgical procedure for the complete repair of Tetralogy of Fallot, a congenital heart defect. This service is billable for the surgeon (A), assistant (B), and anaesthesiologist (C), with fees for the latter two calculated based on basic and time units.$1408.85
- R721Arterial repair of transpositionA surgical procedure for the arterial repair of transposition of the great vessels.$1739.20
- R722Total anomalous pulmonary venous drainageSurgical repair of total anomalous pulmonary venous drainage, a congenital heart defect where pulmonary veins do not connect to the left atrium. This major cardiovascular procedure is eligible for surgeon, assistant, and anaesthetist billing.$1263.35
- R754Ligation or division patent ductus - infant or childA surgical procedure for the ligation or division of a patent ductus arteriosus in an infant or child. This fee is for the surgeon's professional service.$525.75
- R755Ligation or division patent ductus - adolescent or adultSurgical ligation or division of a patent ductus arteriosus in an adolescent or adult patient.$801.10
- R759Congenital heart proceduresSurgical procedure for congenital heart conditions, such as Blalock, Glenn, Potts, Waterston, or Central shunts.$774.35
- R768Pulmonary artery bandingA surgical procedure to perform banding of the pulmonary artery.$628.95
- R762Creation of ASD by thoracotomy or Sterling EdwardsSurgical creation of an atrial septal defect (ASD) using a thoracotomy or Sterling Edwards approach.$755.80
- R763Creation of ASD by balloon septostomyA cardiovascular surgical procedure to create an atrial septal defect (ASD) using a balloon septostomy technique. This procedure includes surgeon (`<billingCode>R763A</billingCode>`), assistant (`<billingCode>R763B</billingCode>`), and anaesthetist (`<billingCode>R763C</billingCode>`) services.$317.85
- R746Ventricular aneurysmSurgical excision of a ventricular aneurysm, an outpouching or bulge in the wall of a heart ventricle. This is a major cardiovascular surgical procedure.$947.80
- R747Aneurysm of sinus of ValsalvaSurgical excision of an aneurysm of the sinus of Valsalva, which is a bulge in the aortic wall near the aortic valve. This is a major cardiovascular surgery.$783.55
Support devices, pericardium & cardiotomy
- R702Bi-ventricular assist device insertionSurgical procedure for the insertion of a bi-ventricular paracorporeal assist device. This service is only payable when the device is inserted for less than 14 days.$1334.80
- R703Paracorporeal ventricular assist deviceSurgical insertion of a paracorporeal ventricular assist device. This service is only payable if the device has been inserted for 14 or more days.$1443.05
- R705Removal of ventricular assist deviceSurgical removal of a paracorporeal or implantable ventricular assist device that has been in place for 14 or more days. This service includes vessel repair and is billable with after-hours, trauma, and age-based premiums.$508.55
- R748Pericardiectomy - one side openA cardiovascular surgical procedure involving the open removal of one side of the pericardium, the sac surrounding the heart.$635.45
- R712Cardiotomy with explorationA surgical procedure involving an incision into the heart (cardiotomy) for the purpose of exploration. This code includes the fee for the surgeon, as well as billable units for anaesthesia and a surgical assistant.$525.75
- R714Cardiotomy - with removal of tumourSurgical procedure involving an incision into the heart (cardiotomy) for the purpose of removing a tumour. This service is eligible for surgeon, assistant, and anaesthetist fees, which are calculated based on basic and time units.$576.40
- R765Cardiac massage - openSurgical procedure for open cardiac massage. Note: For closed massage, refer to the Critical Care - Diagnostic and Therapeutic Procedures section of the Schedule.$231.30
Long-term care
- W095ConsultationA consultation service rendered by a specialist in Cardiac Surgery for a patient in a non-emergency, long-term care institution.—
- W096Repeat ConsultationA repeat consultation provided by a cardiac surgery specialist for a patient in a long-term care facility. This service follows a previous consultation for the same problem and requires a new referral.—
How to use this cardiac surgery code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to cardiovascular and thoracic surgery (specialty 09) — its own consultation and assessment codes, in-patient visits, premiums and the diagnostics or procedures that make up most of a day — sectioned the way a shift sheet reads. Codes open to every specialty that a cardiac surgery physician also bills (general assessments, forms, special visit premiums) live in the Family Practice and Special visit premiums sets.
Each code links to its full Schedule entry: fee history, restrictions, required diagnoses and the codes it can or cannot be billed with. Fees shown are the current provider or specialist fee; percentage premiums show the percentage they add to the base service.
Common questions
Which consultation or assessment code does cardiovascular & thoracic surgery bill?
The consultations & assessments — office section of this set starts with A095 (Consultation). 4 codes are listed in that section.
What is in the Cardiovascular & Thoracic Surgery code set?
70 OHIP billing codes across 9 sections: Consultations & assessments — office; Hospital in-patient; Coronary surgery; Valve surgery; Aorta; Arrhythmia & devices; Congenital & structural; Support devices, pericardium & cardiotomy; Long-term care. Cardiac surgery consultations and visits, coronary and valve surgery, aortic surgery, arrhythmia and device procedures, congenital repairs and support devices.
Are these the current OHIP fees?
Fees are read from the current Ontario Schedule of Benefits for Physician Services and refreshed hourly. Claims are paid at the fee in force on the service date, so always confirm the effective date on the code page.
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