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Billing code

D040A — Patellar dislocation – closed reduction without anaesthetic

Kneecap dislocation, no anaesthetic

Bill for putting a dislocated kneecap back in place without surgery and without an anaesthetic.

Watch for: If an anaesthetic is given, bill D031 instead.

Code

D040A

Description

Patellar dislocation – closed reduction without anaesthetic

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Closed reduction of a dislocated kneecap (patella) without anaesthetic. With anaesthetic it is D031.

What it covers

D040 is closed reduction of a patellar dislocation without anaesthetic (N49). With anaesthetic it is D031 (N49).

Open reduction is D041 (early) or R255 (late). Repair of recurrent dislocation is R403 (N49).

Billing rules

• A closed reduction is reduction of a fracture or dislocation by non-operative methods, including traction (N1).
• The major pre-operative visit (the consultation or assessment) can be billed in addition (N1).
• A cast or corrective splint applied during the first 2 weeks is included in the fracture or dislocation fee; later casts are billed from the cast listings (N7).
• Repeat reductions of the same fracture or dislocation: claim the full fee for the final reduction and after-care; earlier reductions by the same surgeon are claimed at 85% (N2).
• If you transfer the patient to another physician for after-care, bill 75% of the listed fee; the physician giving after-care bills visit fees (N2).
• Multiple fractures or dislocations: the major one is paid at 100% and each of the others at 85% (N1).
• Non-elective fracture or dislocation care started in the evening, on a weekend or holiday, or at night takes an after-hours premium: E412 (+20%) or E413 (+40%) for an Emergency Department Physician billing H codes, or E409 (+50%) or E410 (+75%) for other physicians (GP103, GP104).
• Patients under 16: payment is increased by 10% to 30% depending on age (GP64).

Often billed with

• E412/E413 or E409/E410 when non-elective and done after hours (GP104).

Related codes: D031, D041, R255, R403, D038, F085

Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Knee, page N49.

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