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By practice setting
Emergency Medicine OHIP billing codes
Shift sheet for Emergency Department Physicians: assessments by time tier, premiums, critical care and the procedures that come through the door.
244 codes in 35 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 12 is in the full Emergency Medicine listing.
Assessments — weekday daytime
Mon–Fri 08:00–17:00
- H101Minor assessmentA brief assessment by an Emergency Department Physician for an unscheduled patient in an emergency department or hospital urgent care clinic, rendered during daytime hours (08:00h to 17:00h) on a weekday.$22.65
- H102Comprehensive assessment and careA comprehensive assessment and care service provided by an Emergency Department Physician to an unscheduled patient in an emergency department or hospital urgent care clinic. This service is for visits during daytime hours (08:00h-17:00h) on weekdays.$56.70
- H103Multiple systems assessmentA multiple systems assessment rendered by an Emergency Department Physician for an unscheduled patient. This code applies to services rendered in an Emergency Department or Hospital Urgent Care Clinic on weekdays between 08:00h and 17:00h.$46.65
- H104Re-assessmentA re-assessment rendered by an Emergency Department Physician in an emergency department or hospital urgent care clinic during daytime hours (08:00h to 17:00h) on a weekday.$22.75
Assessments — weekday evening
Mon–Thu 17:00–24:00
- H131Minor assessmentA minor assessment for an unscheduled patient rendered by an *Emergency Department Physician* in an Emergency Department or Hospital Urgent Care Clinic during evening hours (17:00h to 24:00h) on a weekday.$30.05
- H132Comprehensive assessment and careA comprehensive assessment and care service provided by an Emergency Department Physician to an unscheduled patient in an Emergency Department or Hospital Urgent Care Clinic during evening hours (17:00h to 24:00h) on weekdays.$75.40
- H133Multiple systems assessmentA multiple systems assessment rendered by an Emergency Department Physician to an unscheduled patient in an Emergency Department or Hospital Urgent Care Clinic on a Monday to Friday evening, between 17:00h and 24:00h.$61.50
- H134Re-assessmentA re-assessment rendered by an Emergency Department Physician to an unscheduled patient in a hospital emergency department or Hospital Urgent Care Clinic during evening hours (17:00h to 24:00h) on a Monday to Thursday.$30.05
Assessments — nights
Every day 00:00–08:00
- H121Minor assessmentA minor assessment provided by an Emergency Department Physician to an unscheduled patient during night hours (00:00h to 08:00h).$39.85
- H122Comprehensive assessment and careA comprehensive assessment and care provided by an Emergency Department Physician to an unscheduled patient during night hours (00:00h to 08:00h).$99.60
- H123Multiple systems assessmentA multiple systems assessment rendered by an Emergency Department Physician for an unscheduled patient during night hours (00:00h to 08:00h).$80.95
- H124Re-assessmentA re-assessment rendered by an Emergency Department Physician to an unscheduled patient in an emergency department or hospital urgent care clinic during night hours (00:00h to 08:00h).$39.80
Assessments — weekends, holidays & Friday evenings
Sat, Sun & holidays 08:00–24:00 · Fri 17:00–24:00 · Dec 25–31
- H151Minor assessmentA brief assessment by an Emergency Department Physician for an unscheduled patient, payable only for services rendered on Saturdays, Sundays, or Holidays between 08:00h and 24:00h.$34.15
- H152Comprehensive assessment and careA comprehensive assessment and care provided by an Emergency Department Physician to an unscheduled patient in an emergency department or Hospital Urgent Care Clinic. This service is for visits on Saturdays, Sundays, or Holidays between 08:00h and 24:00h.$85.70
- H153Multiple systems assessmentA multiple systems assessment rendered by an Emergency Department Physician to an unscheduled patient on a Saturday, Sunday, or Holiday during daytime and evening hours (08:00h to 24:00h).$69.60
- H154Re-assessment A re-assessment rendered by an Emergency Department Physician to an unscheduled patient in an emergency department or hospital urgent care clinic on a Saturday, Sunday, or Holiday between 08:00h and 24:00h.$34.15
Admissions & consultations
- H105In-patient interim admission ordersFor writing interim admission orders by an Emergency Department Physician following an initial assessment, when the patient is admitted from an emergency department or Hospital Urgent Care Clinic.$29.05
- C933On-call admission assessmentAn on-call admission assessment by a family or general practitioner for a non-emergency hospital in-patient, subject to the same conditions as billing code <billingCode>A933</billingCode>.$82.00
- C004General re-assessmentGeneral re-assessment (Hospital In-patient)$38.35
- H055Emergency Department Physician on Duty ConsultationA consultation rendered by an on-duty specialist in emergency medicine (FRCP) in an emergency department or other critical care area of a hospital. This service requires a written referral and has specific payment rules and location restrictions.—
- H065Consultation in Emergency MedicineA consultation in Emergency Medicine rendered by a non-specialist physician in an emergency department or hospital urgent care clinic setting. This service follows standard consultation requirements, including a written request from a referring provider.$95.60
- A813Midwife or Aboriginal Midwife-Requested Assessment (MAMRA)$111.70
Critical care — life-threatening
- G521Life threatening critical care - first 1/4 hourThe first quarter-hour of critical care provided by a physician to a critically ill or injured patient experiencing acute, life-threatening vital organ system failure.$125.10
- G523Life threatening critical care - second 1/4 hourPayable for the second 15-minute interval (or part thereof) of life-threatening critical care for a patient with an illness or injury that acutely impairs one or more vital organ systems.$64.50
- G522Life threatening critical care - after first ½ hourA time-based fee for providing life-threatening critical care to a critically ill or injured patient, per quarter-hour (or part thereof), after the first half-hour of care has been provided with the physician in full devotion.$42.50
Critical care — other resuscitation
- G395Other critical care - first 1/4 hourThis code is for the first quarter-hour (or part thereof) of a resuscitation service for a patient in an emergency with a potential threat to life or limb, but not yet meeting the criteria for life-threatening critical care. It includes resuscitation assessment and procedures.$64.70
- G391Critical care - fourth and subsequent physiciansA time-based fee for providing critical care, billed per quarter-hour. This applies to the fourth and subsequent physicians in a life-threatening critical care situation, or to quarter-hours following the initial resuscitation period (`<billingCode>G395</billingCode>`) in other critical care scenarios.$34.35
Phone consults & CritiCall
- K734Physician to physician telephone consultation - Referring physicianA telephone consultation initiated by a referring physician or nurse practitioner, who is on duty in an emergency department or hospital urgent care clinic, to request the opinion of a consultant physician due to the complexity, seriousness, or obscurity of a patient's case.$37.05
- K735Physician to physician telephone consultation - Consultant physicianPayable to a consultant physician on duty in an emergency department or hospital urgent care clinic for providing a telephone consultation to a referring physician or nurse practitioner, requested due to the complexity, seriousness, or obscurity of a case.$47.75
- K736CritiCall telephone consultation - Referring physicianA telephone consultation arranged via CritiCall by a referring physician or nurse practitioner who is on duty in an emergency department or hospital urgent care clinic to obtain advice from a consultant physician.$37.05
- K737CritiCall telephone consultation - Consultant physicianA telephone consultation provided by a consultant physician on duty in an emergency department or hospital urgent care clinic, arranged by CritiCall Ontario, to advise a referring provider on patient management.$47.75
Counselling & mental health
- K005Individual careTime-based service for individual primary mental health care, calculated in units of ½ hour or major part thereof. This service cannot be billed on the same day as other consultations or assessments by the same physician for the same patient, unless for a clearly different diagnosis.$80.00
- K007Individual careIndividual psychotherapy for mental illness, behavioural maladaptations, or emotional problems. This is a time-based service billed in units of 30 minutes, with the first unit requiring a minimum of 20 minutes of direct patient contact.$80.00
- K013Individual careTime-based individual counselling for a patient, limited to the first three units per 12-month period, combined with group counselling (<billingCode>K040</billingCode>). It is a visit dedicated solely to an educational dialogue with a physician.$80.00
- K002Interviews with relatives or authorized decision makerA time-based interview with a patient's relatives or authorized decision-maker when medically necessary information cannot be obtained from the patient. Requires a separate, booked appointment of at least 20 minutes.$80.00
- K003Interviews with Children’s Aid Society (CAS) or legal guardianA time-based interview with a Children's Aid Society (CAS) or legal guardian about a patient when information cannot be obtained from the patient. This service must be a separate, booked appointment lasting at least 20 minutes and is claimed per half-hour unit.$80.00
- K004Family psychotherapyFamily psychotherapy for two or more family members in attendance at the same time. This is a time-based service billed in units of ½ hour (or major part thereof).$86.85
- K014Counselling for transplant recipients, donors or families of recipients and donorsTime-based counselling for transplant recipients, donors, or their families to provide information for informed decision-making regarding organ transplantation. It is claimed under the recipient's or donor's health number and requires a pre-booked appointment.$80.00
- K015Counselling of relatives - on behalf of catastrophically or terminally ill patientA time-based counselling service for one or more relatives of a catastrophically or terminally ill patient. This service is billed in half-hour units and must be claimed under the patient's health number.$80.00
- K018Sexual Assault Examination - FemaleAn examination for the investigation of an alleged sexual assault in a female patient, including documentation using the official evidence kit.$358.45
- K021Sexual Assault Examination - MaleA comprehensive examination of a male patient following an alleged sexual assault, including completion of the official evidence kit.$282.75
- K028STI managementA time-based, all-inclusive service providing assessment and counselling for patients with a suspected Sexually Transmitted Disease (STD) or potential blood-borne pathogen exposure. Billed in 30-minute units.$80.00
- K623Application for psychiatric assessmentA psychiatric assessment for the purpose of completing a Form 1 application under the *Mental Health Act*. This service includes the necessary history, examination, and required notifications.$133.60
Forms & certificates
- K070Home care applicationCompletion of home care referral form$34.75
- K031Mandatory Blood Testing Act - Physician ReportA service for the completion of Form 1, the physician report required under the Mandatory Blood Testing Act.$105.20
- K035Mandatory Reporting of Medical Condition to the Ontario Ministry of TransportationService for a physician's mandatory reporting of a patient's medical condition to the Ontario Ministry of Transportation (MTO), as required by the *Highway Traffic Act*.$36.25
- A771Certification of death$24.20
- A777Intermediate assessment - Pronouncement of death$44.55
Ambulance transfers
- K101Ground ambulance transfer with patientPayable per quarter hour for constant attendance with a patient during ground ambulance transport. This service is for all aspects of care during transfer and requires a written explanation for payment as it is assessed on an Independent Consideration (IC) basis.$60.00
- K111Air ambulance transfer with patientPayable for constant attendance with a patient during an air ambulance transfer, billed per quarter hour or part thereof. This service is assessed on an Independent Consideration (IC) basis.$60.00
- K112Trip to collect patient or return trip without patient to place of origin following air or ground ambulance transferPayable for the return trip without a patient to the place of origin following an air or ground ambulance transfer. This is a time-based fee calculated per 15 minutes or major part thereof and is assessed on an Independent Consideration (IC) basis.$21.10
Airway
- G211Endotracheal intubation for resuscitationEndotracheal intubation performed for resuscitation. This service is not payable if performed as part of an anaesthetic procedure for a subsequent surgery.$38.35
- Z325Emergency tracheotomyAn emergency surgical tracheotomy for life-threatening situations where the patient is not intubated. This code does not apply to percutaneous tracheostomy or similar airway punctures.$474.65
- Z326Change of tracheostomy tubeA surgical procedure for changing a tracheostomy tube. This is designated as an Independent Operative Procedure (IOP).$12.50
Lines, access & injections
- Z459Arterial punctureA procedure involving the puncture of an artery to obtain a blood sample, commonly for blood gas analysis.$10.20
- G268Cannulation of artery for pressure measurementsA procedure for the cannulation of an artery, which may include a cut down, for the purpose of taking pressure measurements. This code is subject to several billing restrictions with other vascular procedures.$31.25
- G270Intraosseous infusionA therapeutic procedure listed under Diagnostic and Therapeutic Procedures for establishing an intraosseous infusion line for vascular access.$23.90
- G380Cutdown including cannulation as necessaryA surgical procedure to gain intravenous access by making an incision to expose a vein and inserting a cannula.$27.05
- G372Intramuscular, subcutaneous or intradermal injection with visitA single intramuscular, subcutaneous, or intradermal injection given during a visit with another service, or as an additional injection when multiple injections are given. This service can be delegated to a physician's employee under specific conditions.$4.55
- G376Intravenous injection or infusion - Newborn or infantAn intravenous procedure, such as for cryoprecipitate infusion, performed on a patient from birth up to two years of age.$10.20
- G379Intravenous injection or infusion - Child, adolescent or adultProvides for an intravenous (IV) infusion for a child, adolescent or adult. This includes cryoprecipitate infusion but is not payable with x-rays or for injections into an established IV line, except for <billingCode>G381</billingCode>.$6.15
- G480Venipuncture - infantVenipuncture (drawing blood from a vein) performed on an infant, defined as a patient from 29 days of age up to, but not including, 2 years of age.$9.90
- G482Venipuncture - childVenipuncture procedure for a child (age 2 to 15 years inclusive). This is a common procedure that may be delegated in an office setting.$7.35
- G489Venipuncture - adolescent or adultVenipuncture for an adolescent (16-17 years of age) or adult (18+ years old). This service is not insured for monitoring weight loss programs and may be delegated to an appropriate employee in the physician's office.$3.54
Abscess, cyst & foreign body
- Z101Abscess or haematoma - Local anaesthetic - subcutaneous - one$28.20
- Z102Abscess or haematoma - General anaesthetic - subcutaneous - oneZ102 is a surgical procedure for an abscess or haematoma, performed under general anaesthetic, subcutaneous, one. Anaesthesia services are calculated based on basic and time units. Surgical assistant services are not eligible for payment with this code.$48.60
- Z103Abscess or haematoma - Local anaesthetic - palmar or plantar spacesA surgical procedure from the Musculoskeletal System section of the Schedule. As a 'Z' prefix procedure, it has specific payment rules regarding admission assessments, which are generally considered specific re-assessments if the surgeon has seen the patient previously for the same illness (see <SectionPages>GP23</SectionPages>).$48.60
- Z104Abscess or haematoma - Local anaesthetic - perianalRepresents a surgical procedure from the Z-section of the schedule for which specific details are not provided in the source text. General surgical rules and applicable premiums apply.$33.25
- Z105Abscess or haematoma - General anaesthetic - perianalRepresents a surgical procedure from Part Z of the Schedule. The specific details for <billingCode>Z105</billingCode> were not provided in the context, but general rules for surgical procedures apply.$72.30
- Z114Foreign body removal - local anaestheticA surgical procedure code with a fixed fee. Specific details for Z114 are not available in the provided context, but general rules for surgical procedures apply, including eligibility for certain premiums.$27.65
- Z115Foreign body removal - general anaestheticA surgical procedure not further specified in the provided context. As a surgical code, it allows for billing by a surgeon (suffix A), an assistant (suffix B), and an anaesthetist (suffix C).$97.30
- R517Foreign body removalSurgical procedure performed on the musculoskeletal system. This service is eligible for anaesthesia but not for a surgical assistant.$107.70
- Z122Cyst, haemangioma, lipoma - single lesion - face or neck - local anaestheticsingle lesion$42.20
- Z139Aspiration of cystA procedure for the aspiration of one or more cysts from the breast.$37.20
- Z140Drainage of intramammary abscess or haematomaDrainage of a single or multiloculated abscess or hematoma within the breast, performed under local anesthesia.$33.00
Lacerations — simple
- Z176Repair of laceration - up to 5 cmRepair of a simple laceration up to 5 cm in length. Fee is reduced by 50% if closed with tissue adhesives.$21.90
- Z175Repair of laceration, 5.1 to 10 cmRepair of a simple laceration measuring 5.1 to 10.0 cm in length, not meeting the criteria for complex repair.$39.35
- Z179Repair of laceration - 10.1 to 15 cmSurgical repair of a simple laceration measuring between 10.1 cm and 15 cm in length, not on the face and not requiring layered closure or tying of bleeders.$55.20
- Z191Repair of laceration, more than 15.1 cm, other than faceSurgical repair of a simple laceration greater than 15.1 cm in length on a body area other than the face.$84.70
Lacerations — face & complex
- Z154Repair of laceration - up to 5 cm if on face and/or requires tying of bleeders and/or closure in layersSurgical repair of a laceration up to 5 cm in length, located on the face, and/or requiring the tying of bleeders or closure in layers.$39.35
- Z177Repair of laceration, 5.1 to 10 cm, complexRepair of a laceration 5.1 to 10 cm in length. This service applies if the laceration is on the face or requires complex closure, such as tying bleeders or layered suturing.$78.15
- Z190Laceration repair, 10.1 to 15 cm, complexSurgical repair of a laceration between 10.1 cm and 15 cm in length, which is either located on the face, requires the tying of bleeders, or requires closure in layers.$111.20
- Z192Repair of laceration - more than 15.1 cm - on faceSurgical repair for a facial laceration greater than 15.1 cm in length. This is a surgical procedure allowing for surgeon, assistant, and anaesthetist fees, with specific add-ons and payment rules.$169.75
- Z187Complex laceration repair, faceA complex repair of a facial laceration requiring a minimum of 20 minutes of surgical time and involving either anatomical alignment of key facial features, closure of three or more layers, or ligation of multiple bleeding vessels.$101.15
- Z188Complex laceration repair, anatomical area other than faceRepair of a complex laceration on the body, excluding the face and zone 1 of digits, that requires a minimum of 20 minutes to perform and involves either multi-layer closure or ligation of multiple bleeding vessels.$101.15
- Z189Complex repair, digit, zone 1 repair, without soft tissue lossComplex repair of a zone 1 digit injury without soft tissue loss, requiring a minimum of 20 minutes of repair time. Paid per digit.$101.15
Tendon repair
- R578Suture extensor tendon and/or open repair acute or chronic boutonniere deformityRepresents a cardiovascular surgical procedure. Payment for the surgeon (suffix A) includes pre-operative assessment and normal post-operative care. Fees for assistant (suffix B) and anaesthesia (suffix C) are calculated based on time and basic units.$276.10
- R585Suture flexor tendon - singleSurgical procedure for suture of a single flexor tendon. Assistant and anaesthesia services are eligible.$433.10
Wound & burn debridement
- Z080Debridement of wound(s) and/or ulcer(s) extending into subcutaneous tissue - oneDebridement of one wound or ulcer extending into subcutaneous tissue. The service must be rendered personally by the physician, involve a minimum of 10 minutes of debridement time, and includes any necessary dressing.$21.90
- Z081Debridement of two wounds or ulcers extending into subcutaneous tissueDebridement of two wounds or ulcers extending into subcutaneous tissue. This service must be rendered personally by the physician for a minimum of 10 minutes.$32.90
- Z082Debridement of wound(s) and/or ulcer(s) extending into subcutaneous tissue - threeDebridement of three wounds or ulcers that extend into subcutaneous tissue. This service requires a minimum of 10 minutes of debridement time and must be rendered personally by the physician. Refer to <SectionPages>M10</SectionPages>.$49.30
- R637Debridement and excision, per % of total body treated other than hand, head or neckSurgical debridement and excision of burned tissue performed outside of an operating room. This service is paid per percentage of total body surface area treated, excluding the hand, head, or neck.$32.50
- R660Burn debridement and excision - hand - each digitPerforms debridement and excision for burns on a single digit of the hand, in a setting outside of the operating room.$31.65
- R661Burn debridement and excision - dorsum, palmSurgical debridement and excision of a burn on the dorsum or palm of the hand, performed outside of an operating room. This service is billable for each site (dorsum or palm) treated.$52.55
- R662Burn debridement and excision - nose, cheek, lip, ear, forehead, scalp, neck, eyelidSurgical debridement and excision of a burn on a specified head or neck area, such as the nose, cheek, lip, ear, forehead, scalp, or neck. This service is performed outside of an operating room and is billable for each distinct site treated.$31.65
Gastrointestinal
- Z543Anoscopy (proctoscopy)Anoscopy (proctoscopy) is an endoscopic examination of the anus and rectum. This service is not separately payable when performed concurrently with certain other rectal procedures, such as haemorrhoid excision.$8.70
- Z535Sigmoidoscopy with rigid scopeA sigmoidoscopy with or without anoscopy, performed using a rigid scope. This is a diagnostic endoscopic procedure of the rectum.$36.80
- Z564Open lavage of peritoneal cavity for diagnosis without manual exploration of peritoneal cavityA surgical procedure involving an open wash-out (lavage) of the peritoneal cavity to obtain a sample for diagnosis, without manually exploring the abdominal cavity.$73.60
- Z756Fecal disimpaction - no anaestheticA manual procedure to remove impacted feces from the rectum, performed without the use of anaesthesia.$46.00
- Z541Dilation and/or disimpaction or removal of foreign body under general anaestheticSurgical dilation, fecal disimpaction, or removal of a foreign body from the rectum, performed under general anaesthesia as a standalone procedure. See also <billingCode>Z756</billingCode> for the same service without anaesthetic.$66.50
- Z520Change of gastrostomy tubeA procedure for the replacement of a gastrostomy tube. The '#' prefix indicates that costs for premises, equipment, and supplies are funded through the facility and are not billable to the patient.$10.65
- Z538Reduction of prolapseA surgical procedure for the reduction of a prolapse.$25.25
- Z545Thrombosed haemorrhoid(s)Incision of one or more thrombosed haemorrhoids. This service includes anoscopy (<billingCode>Z543</billingCode>). An additional premium, <billingCode>E542</billingCode>, is payable if the procedure is performed outside of a hospital.$25.25
- G355Gastric lavage - diagnosticA diagnostic procedure involving gastric lavage (stomach washout), intended to obtain stomach contents for analysis.$9.60
- G356Gastric lavage - therapeuticA procedure for therapeutic gastric lavage, which may or may not include ice water lavage.$33.80
- Z590Paracentesis - for diagnostic sampleA surgical procedure involving the aspiration of peritoneal fluid for diagnostic sampling. An additional fee (<billingCode>E542</billingCode>) is payable when performed outside of a hospital.$31.30
- Z591Paracentesis with therapeutic drainageA surgical procedure for the aspiration of fluid from the peritoneal cavity (paracentesis) primarily for therapeutic drainage, which may also include obtaining a diagnostic sample.$57.65
Chest & cardiovascular
- Z437Cardioversion (electrical and/or chemical)Cardioversion, using electrical or chemical methods, to restore normal heart rhythm. This service is limited to three sessions per patient, per day.$92.45
- G313Electrocardiogram - professional componentProvides payment for the professional component of a twelve-lead electrocardiogram (ECG), which requires a written interpretation. Payment is restricted for routine pre-operative screening and asymptomatic patients.$4.55
- G517Ankle pressure determinationA unilateral or bilateral blood flow study using Doppler or other methods to determine ankle pressure, which includes calculating the ankle-arm index systolic pressure ratio. This service is not payable during surgery, a post-operative hospital stay, or in conjunction with <billingCode>J200</billingCode>.$10.05
- G115External cardiac pacing (temporary transthoracic)A procedure for external cardiac pacing (temporary transthoracic), billable once per 24-hour period. This code cannot be billed with resuscitative service codes <billingCode>G521</billingCode>, <billingCode>G522</billingCode>, <billingCode>G523</billingCode>, <billingCode>G395</billingCode>, and <billingCode>G391</billingCode>.$46.30
- Z443Insertion of temporary endocardial electrodeA surgical procedure for the insertion of a temporary endocardial electrode, which is a component used in cardiac pacing.$154.10
- Z401Aspiration of pericardiumA surgical procedure involving the aspiration (withdrawal of fluid) from the pericardial sac surrounding the heart.$131.70
- Z332Aspiration for diagnosis or therapeutic drainagePerforms a therapeutic aspiration of the lung and pleura, also known as thoracentesis, to drain fluid, with or without taking a diagnostic sample. This is an Independent Operative Procedure (IOP).$104.40
- Z341Tube thoracostomy for closed drainage (chest tube)A surgical procedure for the insertion of a chest tube for closed drainage, typically to remove air or fluid from the pleural space.$76.80
Neuro & nerve blocks
- Z804Lumbar puncturePerforms a lumbar puncture (spinal tap), a procedure to collect cerebrospinal fluid. This service includes the injection of medication and the use of image guidance, if performed.$150.00
- G060Peripheral nerve block, majorA major peripheral nerve block for acute pain management, such as a block of the radial, median, ulnar, femoral, or sciatic nerve, a paravertebral block, an ankle block, or a fascia iliaca block.$55.00
- G061Peripheral nerve block, minorA minor peripheral nerve block for acute pain management, including specific nerve blocks like ilioinguinal, intercostal, or TAP block. This service is limited to a maximum of 4 services per patient, per physician, per day.$30.00
- G219Infraorbital nerve blockA percutaneous injection for an infraorbital nerve block.$34.20
- G220Intercostal nerve blockA percutaneous nerve block for a single intercostal nerve. Use <billingCode>G221</billingCode> for each additional intercostal nerve block performed during the same session.$34.20
- G221Intercostal nerve - additionalThis service is for each additional intercostal nerve block performed after the initial block, which is billed using billing code <billingCode>G220</billingCode>.$16.95
- G218Ilioinguinal and iliohypogastric nerves blockA percutaneous nerve block injection targeting the ilioinguinal and iliohypogastric nerves.$54.65
- G225Mental branch of mandibular nervePerforms a percutaneous nerve block of the mental branch of the mandibular nerve for therapeutic purposes.$34.20
- G250Maxillary or mandibular division of trigeminal nerveA percutaneous nerve block for the maxillary or mandibular division of the trigeminal nerve.$75.10
- G231Somatic or peripheral nerves not specifically listed - one nerve or siteProvides for a percutaneous nerve block of a single somatic or peripheral nerve or site that is not otherwise specified in the Schedule of Benefits.$34.10
- G260Major plexus blockA procedure for the block of a major nerve plexus such as the brachial, lumbar, sacral, deep cervical, or a combined 3-in-1 block which must include the femoral, obturator, and lateral femoral cutaneous nerves.$80.00
- G224Nerve block by same physician performing the procedurePayable for a major or minor peripheral nerve block, major plexus block, neuraxial injection, or intrapleural block for post-operative pain control with a duration of action over 4 hours, when rendered by the same physician performing the main procedure.$15.55
ENT & dental
- G420Ear syringing and/or extensive curetting or debridementPerformance of ear syringing and/or extensive curetting or debridement on one or both ears. This service is insured only under specific conditions, such as hearing loss from impacted wax unresponsive to cerumenolytics, or when immediate removal is medically necessary for diagnosis or therapy.$13.15
- G403Particle repositioning maneuvre for benign paroxysmal positional vertigoA therapeutic procedure performed for benign paroxysmal positional vertigo.$21.70
- Z915Endoscopy of ear - simpleSimple removal of a foreign body from the external ear. This service is not payable if claimed for the removal of cerumen (ear wax) only.$10.55
- Z866Endoscopy - complicated, general anaestheticRemoval of a complicated foreign body from the external ear, performed under general anaesthetic.$50.90
- Z311Removal of foreign body - local anaestheticSurgical removal of a foreign body from the nose under local anaesthetic. This is an Independent Operative Procedure (IOP).$10.55
- Z301Drainage of abscess or haematomaSurgical drainage of a nasal abscess or hematoma. This is an Independent Operative Procedure (IOP) typically performed in a hospital or ICHSC setting.$55.60
- Z314Cauterization - unilateralUnilateral cauterization of the nose for the treatment of epistaxis (nasal hemorrhage). This is an Independent Operative Procedure (IOP).$11.50
- Z315Anterior packing - unilateralUnilateral anterior nasal packing for the control of epistaxis (nasal hemorrhage).$15.35
- Z316Posterior packing - unilateral or bilateralPosterior nasal packing, either unilateral or bilateral, for the treatment of epistaxis (nasal hemorrhage). This is an Independent Operative Procedure (IOP).$35.50
- F136Nasal bones - closed reduction$102.35
- Z322Laryngoscopy with removal of foreign bodyA direct laryngoscopy procedure to remove a foreign body from the larynx. This is an Independent Operative Procedure (IOP).$106.45
- Z324Laryngoscopy - with biopsy or removal of foreign bodyAn indirect laryngoscopy for the purpose of performing a biopsy or removing a foreign body from the larynx. This is an Independent Operative Procedure (IOP).$44.70
- Z506Drainage of oral abscess or haematomaSurgical drainage of an abscess or hematoma located in the oral cavity. This procedure includes management of related structures in the nasopharynx, oropharynx, and hypopharynx unless specified otherwise.$50.90
- Z510Drainage of pharyngeal abscess or haematomaA surgical procedure for the drainage of a pharyngeal abscess or haematoma, which can involve the nasopharynx, oropharynx, or hypopharynx.$91.10
- E318Incision and drainage of extensive haematoma of pinna with packing of ear and external compression dressing - local anaestheticSurgical incision and drainage of an extensive haematoma of the outer ear (pinna) under local anaesthetic, including packing and applying a compression dressing.$92.40
- D062Temporomandibular joint - closed reductionA surgical procedure for the closed reduction of a dislocated temporomandibular joint (TMJ). This service is not payable in addition to certain mandible fracture repair codes.$51.65
- S023Extraction of tooth - singleProvides for the complete care of a single tooth extraction. This is a surgical procedure that may involve anaesthesia and surgical assistance, with fees calculated based on units. For additional extractions, see <billingCode>E700</billingCode>.$24.90
- E700Extraction of tooth - each additional toothAn add-on fee for each additional tooth extracted during the same surgical session, to be claimed in conjunction with the primary extraction code S023.$13.40
Eye
- Z847Removal of one embedded foreign bodySurgical removal of a single embedded foreign body from the cornea, performed under local anaesthetic.$33.00
- Z848Removal of two embedded foreign bodiesSurgical procedure for the removal of two embedded foreign bodies from the cornea under local anaesthesia.$45.00
- G435TonometryTonometry is a diagnostic procedure to measure intraocular pressure. This service cannot be claimed in conjunction with an ophthalmological consultation or specific assessment as this is an included component of those services.$5.10
- E199Laceration, full thicknessSurgical repair of a full thickness laceration of the eyelid, not including the lid margin.$452.65
- E198Laceration, full thickness - including lid marginSurgical repair of a full-thickness laceration of the eyelid that includes the lid margin. This service is typically performed under general anaesthetic in a hospital setting and is eligible for anaesthesia fees.$573.15
- Z854Drainage of abscess - local anaestheticSurgical drainage of an abscess of the eyelid performed under local anaesthetic.$60.00
- E235Cantholysis - when primary procedure$107.50
Genitourinary
- Z611Catheterization - hospital or officeHospital-based urinary catheterization performed personally by a physician for acute retention, catheter change, or medication instillation.$9.15
- Z608Manual catheter declotting and irrigation of bladderA procedure for the manual declotting and irrigation of a bladder catheter.$58.65
- G900Residual urine measurement by ultrasoundMeasures residual urine volume using ultrasound. This service has specific billing restrictions and cannot be claimed with certain other pelvic ultrasound or urodynamic studies.$12.70
Obstetrics & gynaecology
- P006Vaginal deliveryVaginal delivery of an infant. This service includes the repair of a first or second-degree tear or episiotomy extension.$512.65
- P009Attendance at labour and deliveryPayable to a physician, other than an obstetric consultant, for attending a labour and delivery to assist at a vaginal delivery or surgery, provide anaesthesia, or resuscitate the newborn.$512.65
- A920Medical management of early pregnancy - initial service$193.70
- A922Medical management of ectopic pregnancy - initial service$249.75
- S768Spontaneous abortion, incomplete - including D&CSurgical management for a spontaneous, incomplete abortion, a procedure that includes dilatation and curettage (D&C).$113.40
- Z714Abscess of vulva, Bartholin or Skene’s gland - incision and drainageIncision and drainage of an abscess of the vulva, Bartholin's gland, or Skene's gland, performed under local anaesthetic.$25.40
- Z715Abscess of vulva, Bartholin or Skene’s gland - incision and drainage - general anaestheticSurgical incision and drainage of an abscess of the vulva, Bartholin's gland, or Skene's gland, performed under general anaesthetic.$102.05
- Z716Marsupialization of Bartholin’s cyst or abscessA surgical procedure for the treatment of a Bartholin's gland cyst or abscess by creating a permanent opening for drainage (marsupialization).$110.95
- Z728Incision and drainage of cyst, abscess or haematomaSurgical procedure for the incision and drainage of a vaginal cyst, abscess, or haematoma. This service is eligible for anaesthesia payment.$97.20
- G365Collection of cervical cancer screening specimen(s)Payable for the collection of a specimen for cervical cancer screening. An additional amount (<billingCode>E430</billingCode>) is payable when performed outside of a hospital or ICHSC, and this service is included in the monthly management fee for nursing home patients (W010).$12.00
- Z735Examination and/or dilatation under general anaestheticA procedure for the examination and/or dilatation of the vagina under general anaesthetic. This service may include the insertion or removal of an IUD and is only billable when it is the sole procedure performed.$56.70
- Z432Examination under anaesthesiaPayable for an examination under anaesthesia (EUA), which may include removing a vaginal foreign body. This is payable only when it is the sole procedure performed by the examining physician and requires an applicable diagnostic code.$54.10
Fractures & dislocations — hand & wrist
- F004Phalanx fracture - no reduction, rigid immobilizationManagement of a non-displaced phalanx fracture through the application of rigid immobilization, without the need for surgical or manual reduction.$49.20
- F005Phalanx - closed reductionA surgical procedure for the closed reduction of a phalanx fracture, which involves setting the broken bone without surgery.$99.25
- F006Intra-articular closed reductionClosed reduction of an intra-articular fracture of the hand or wrist. This surgical procedure is eligible for various add-on premiums for age, trauma, and after-hours services.$119.75
- F008Metacarpal fracture - no reduction, rigid immobilizationManagement of one or more metacarpal fractures that do not require reduction, treated with rigid immobilization.$49.20
- F009Metacarpal - closed reductionSurgical service for the closed reduction of a metacarpal fracture. Add-on codes for plaster casting (<billingCode>E584</billingCode>) and for additional metacarpal fractures (<billingCode>E504</billingCode>) may be applicable.$99.25
- F016Closed reduction, one or moreA surgical procedure for the closed reduction of one or more carpal (wrist) bone fractures.$115.10
- F018Scaphoid - no reduction, rigid immobilizationManagement of a scaphoid fracture without reduction, using rigid immobilization. An add-on code, `<billingCode>E584</billingCode>`, is available for applying a plaster cast outside a hospital.$49.20
- F102No reduction, rigid immobilizationThis service describes the rigid immobilization of a carpal fracture without reduction.$49.20
- D001Closed reduction of finger dislocationSurgical procedure for the closed (non-operative) reduction of a dislocated finger joint.$57.50
- D004Closed reduction - Metacarpal/phalangeal dislocationSurgical procedure for the closed reduction of a dislocated metacarpal/phalangeal joint. Additional fees may apply for plaster casting or for reducing additional dislocations.$57.50
- D007Closed reduction of carpal dislocationSurgical procedure for the closed reduction of a dislocation of one or more carpal bones. This is a non-operative manipulation to realign the bone(s).$128.05
Fractures & dislocations — forearm & elbow
- F024Radius and ulnar shaft - no reduction, rigid immobilization$67.75
- F025Radius and ulnar shaft - closed reductionRepresents a surgical procedure on the musculoskeletal system. Payment is for the surgeon's fee, with separate calculations for assistant and anaesthetist services, which are unit-based and eligible for various premiums.$148.50
- F027Radius - distal - no reduction, rigid immobilization$67.75
- F028Radius - distal - closed reduction, under local anaesthetic$109.45
- F029Epicondyle - no reductionThis service provides for the non-operative management of a clavicle (collarbone) fracture, including the initial assessment and normal follow-up care.$67.75
- F031Radius or ulna - no reduction, rigid immobilization$81.30
- F034Olecranon - no reduction, rigid immobilizationSurgical procedure for fracture and/or dislocation, payable to the surgeon. Anaesthesia services are billed separately.$126.25
- F037Epicondyle - closed reductionAn unspecified surgical procedure. Fee information indicates it is eligible for surgeon, assistant, and anaesthetist billing.$126.25
- F039Transcondylar/condylar - no reductionThis service provides for the non-operative (closed) reduction of a mandibular fracture. As a surgical procedure, it is eligible for various premiums including those for age, after-hours services, and trauma.$67.75
- F040Transcondylar/condylar - closed reductionSurgical procedure code, likely related to the integumentary system. The specific description and title are not available in the provided context.$298.35
- D009Closed reduction of elbow joint dislocationSurgical procedure for the closed reduction of a dislocated elbow joint.$84.45
- D012Closed reduction, pulled elbowA non-operative, manual procedure to correct a subluxation or dislocation of the radial head, commonly referred to as 'pulled elbow' or 'nursemaid's elbow'.$39.00
Fractures & dislocations — shoulder & clavicle
- F042Fracture of shaft - no reductionManagement of a fracture of the shaft of the humerus that does not require reduction.$67.80
- F043Fracture of shaft - closed reductionSurgical service for the closed reduction of a fracture of the shaft of the humerus. This procedure may be performed with an assistant and/or anaesthesiologist, whose fees are calculated based on time and base units.$147.60
- F047Tuberosity fracture - no reductionManagement of a fracture of the humerus tuberosity without surgical or manual reduction. This service is for cases where the fracture fragments are in an acceptable position.$67.80
- F048Tuberosity fracture - closed reductionThis code is for the non-surgical procedure to set a fractured shoulder tuberosity (closed reduction).$117.85
- F050Neck with dislocation of head - no reductionManagement of a fracture of the humeral neck with associated dislocation of the head, where no manipulative or surgical reduction is performed.$67.80
- F051Fracture of neck with dislocation of head - closed reductionSurgical procedure for the closed reduction (non-operative realignment) of a fracture of the humeral neck with associated dislocation of the humeral head.$183.80
- F110Clavicle - closed reduction with anaestheticSurgical procedure for the closed reduction of a clavicle fracture, requiring anaesthesia.$62.20
- F119Scapula fracture - no reductionManagement of a fracture of the scapula (shoulder blade) that does not require surgical reduction.$67.80
- D014Acromio-clavicular/sterno-clavicular - no reductionManagement of an acromio-clavicular or sterno-clavicular dislocation where no reduction procedure is performed.$67.80
- D025Acromio-clavicular/sterno-clavicular - closed with anaestheticA surgical procedure for the closed reduction of a dislocated acromio-clavicular or sterno-clavicular joint, performed under anaesthesia.$134.55
- D015Glenohumeral joint - closed reduction without anaestheticA surgical procedure for the closed reduction of a glenohumeral (shoulder) joint dislocation, performed without general or regional anaesthesia.$49.20
- D016Glenohumeral joint - closed reduction with anaestheticSurgical procedure for the closed reduction of a dislocated glenohumeral (shoulder) joint, performed under anaesthesia.$111.40
Fractures & dislocations — pelvis, hip & femur
- F134Closed reduction of anterior and/or posterior pelvic ring fracture(s) and/or dislocation(s)This surgical procedure is for the closed reduction of a pelvic ring fracture.$750.00
- D042Hip dislocationA surgical procedure for the closed reduction (non-operative realignment) of a dislocated hip joint.$268.25
- F094Closed reduction with application of skin traction or Pavlik harness - infantProvides for the closed reduction with application of skin traction or Pavlik harness for an infant.$258.00
Fractures & dislocations — knee & leg
- F085Patella fracture - no reductionManagement of a patellar fracture that does not require surgical reduction.$67.75
- D040Patella - closed reduction - without anaestheticA surgical procedure for the closed reduction of a dislocated patella (kneecap), performed without the use of anaesthesia.$62.20
- D031Patella - closed reduction - with anaestheticPerforms a closed reduction of a dislocated patella, a non-surgical maneuver to reposition the kneecap, while the patient is under anaesthesia.$97.35
- D038Knee dislocation - closed reductionA surgical procedure to perform a closed reduction of a dislocated knee.$207.90
- F078Tibia fracture - no reduction, rigid immobilizationno reduction, rigid immobilization$115.95
- F079Tibia with or without fibula - closed reductionSurgical procedure for the treatment of fractures and/or dislocations. This code is billable by the performing surgeon, with separate calculations for surgical assistants and anaesthetists.$180.05
- F082Fibula fracture - no reduction, rigid immobilizationTreatment for a fibula fracture that does not require surgical realignment, managed with rigid immobilization such as a cast. This fee is for the surgeon's service.$67.75
- F083Fibula - closed reductionSurgical procedure for the closed reduction of a fibula fracture. This service includes the manual manipulation of the bone fragments back into their normal alignment without surgery.$101.25
Fractures & dislocations — ankle & foot
- F074Ankle fracture - no reduction - rigid immobilizationProvides for the non-operative management of an ankle fracture through rigid immobilization, typically with a cast, when no reduction is required.$67.75
- F075Ankle fracture - closed reduction`<billingCode>F075</billingCode>` is a surgical procedure for the closed reduction of an ankle fracture.$144.80
- F104Ankle fracture with tibial Plafond burst - closed reduction and external fixationClosed reduction for an ankle fracture with tibial plafond burst. This is a surgical procedure that includes fees for the surgeon, assistant, and anaesthesia.$363.40
- D035Ankle dislocation - closed reductionA non-operative procedure to manually realign a dislocated ankle joint. This service is eligible for assistant and anaesthesia fees when required.$111.35
- F061Metatarsus fracture - one or moreManagement of a fracture of one or more metatarsal bones, typically without active reduction or rigid immobilization.$49.20
- F062Metatarsus - with rigid immobilizationTreatment for a fracture of one or more metatarsal bones with the application of rigid immobilization, such as a cast. This service does not involve surgical reduction.$67.75
- F063Metatarsus - closed reduction - one or moreSurgical service for the closed reduction of one or more fractures of the metatarsus. This procedure is eligible for assistant and anaesthesia fees.$98.35
- D030Metatarsophalangeal - closed reductionClosed reduction of a metatarsophalangeal dislocation. This is a surgical procedure to realign a joint in the foot without making an incision.$57.50
- F070No reduction os calcis or talar neck/body - rigid immobilizationManagement of an os calcis (heel bone) fracture with rigid immobilization, but without reduction.$97.35
- F071Closed reduction of os calcis fracture or Hawkins type 2 talar neck fractureSurgical procedure for the closed reduction of a fracture of the os calcis (heel bone), performed without surgical incision.$161.45
- F066Tarsus fracture - no reduction - rigid immobilizationManagement of a fracture of the tarsal bones (excluding the os calcis) without performing a reduction, which includes the application of rigid immobilization.$98.10
- F067Closed reduction of tarsus fractureA surgical procedure for the closed reduction (re-alignment without incision) of a fracture of the tarsal bones, excluding the os calcis (heel bone).$165.20
- D033Closed reductionPerforms a closed reduction of a dislocation of the tarsus (foot bones). This surgical procedure does not require an open incision. An add-on code (<billingCode>E584</billingCode>) is available for plaster cast application if performed outside a hospital.$147.60
- F057Intra-articular fracture - I.P. Joint - closed reductionPerforms the closed reduction of an intra-articular fracture of an interphalangeal (I.P.) joint in the foot or ankle.$77.95
- F058Phalanx fracture - closed reduction - oneSurgical service for the closed reduction of a single fractured phalanx in the foot or ankle.$72.35
- F060Open reduction - phalanxAn open reduction of a phalanx fracture of the foot. This is a surgical procedure eligible for surgeon (A), assistant (B), and anaesthetist (C) fees.$276.25
Casts & splints
- Z201Finger cast applicationApplication of a plaster cast to the full arm. This is a surgical procedure that may be delegated to a trained employee under specific supervision rules.$10.25
- Z202HandApplication of a cast. This procedure is listed as a delegatable procedure, meaning it can be performed by a physician's employee under specific conditions.$14.90
- Z203Arm, forearm or wristApplication of a cast, which is a surgical procedure listed in the Musculoskeletal System section of the Schedule. This procedure can be delegated to a trained employee under specific conditions outlined on page <SectionPages>GP62</SectionPages>.$24.10
- Z198ToesApplication of a cast, a surgical procedure that can be delegated to a trained employee in a physician's office under specific conditions.$10.25
- Z213Below knee, knee splintsApplication of a cast, such as for a club-foot. This is a surgical procedure that may be delegated to a trained employee under specific conditions outlined in the Schedule of Benefits.$24.10
- Z211Whole leg (mid thigh to toes)Procedure for the application of a cast. This service is eligible to be delegated to a trained employee under specific supervision and documentation requirements.$28.80
- Z204Removal of plasterRemoval of plaster, not associated with fractures or dislocations within 2 weeks of initial treatment. This procedure is delegable under conditions outlined in the General Preamble.$10.25
Joints
How to use this emergency code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to emergency medicine (specialty 12) — 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 emergency 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 emergency medicine bill?
The assessments — weekday daytime section of this set starts with H101 (Minor assessment), which pays $22.65 under the current Ontario Schedule of Benefits. 4 codes are listed in that section.
What is in the Emergency Medicine code set?
244 OHIP billing codes across 35 sections: Assessments — weekday daytime; Assessments — weekday evening; Assessments — nights; Assessments — weekends, holidays & Friday evenings; Admissions & consultations; Time premiums for non-assessment services; Procedure & trauma premiums; Critical care — life-threatening; Critical care — other resuscitation; Phone consults & CritiCall; Counselling & mental health; Forms & certificates; Ambulance transfers; Airway; Lines, access & injections; Abscess, cyst & foreign body; Lacerations — simple; Lacerations — face & complex; Tendon repair; Wound & burn debridement; Gastrointestinal; Chest & cardiovascular; Neuro & nerve blocks; ENT & dental; Eye; Genitourinary; Obstetrics & gynaecology; Fractures & dislocations — hand & wrist; Fractures & dislocations — forearm & elbow; Fractures & dislocations — shoulder & clavicle; Fractures & dislocations — pelvis, hip & femur; Fractures & dislocations — knee & leg; Fractures & dislocations — ankle & foot; Casts & splints; Joints. Shift sheet for Emergency Department Physicians: assessments by time tier, premiums, critical care and the procedures that come through the door.
Which emergency department assessment code applies at what time?
Emergency Department Physician assessment codes are tiered by time: H101–H104 on weekdays 08:00–17:00, H131–H134 on Monday to Thursday evenings 17:00–24:00, H121–H124 overnight 00:00–08:00, and H151–H154 on Saturdays, Sundays, statutory holidays, Friday evenings and December 25–31. Non-assessment services in the ED add H112 (nights), H113 (weekends, holidays and Friday evenings) or H114 (Monday to Thursday evenings).
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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