Billing code
E494A — Arthroscopic debridement of degenerative cartilage – knee
Knee cartilage debridement
Add to knee arthroscopy (R687 or R699) for substantial debridement of unstable degenerative cartilage flaps causing mechanical symptoms.
Watch for: With R687, it needs Kellgren-Lawrence grade below 3 and 6 months of failed non-surgical treatment, unless the Ministry approved it.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $299.00 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- E494A
- Description
- Arthroscopic debridement of degenerative cartilage – knee
- 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
Arthroscopic add-on for substantial debridement of unstable degenerative cartilage flaps causing mechanical symptoms in the knee.
What it covers
E494 is substantial debridement of 1 or more focal flaps of unstable degenerative articular cartilage causing mechanical symptoms. It includes synovectomy, meniscal trimming and/or chondroplasty when rendered (N46).
It is an arthroscopic add-on to the knee arthroscopy set-up (R687 or R699) (N45, N46). Post-traumatic cartilage uses E498 instead (N46).
Billing rules
- With R687, E494 and E495 need, unless the Ministry gave prior approval: Kellgren-Lawrence grade below 3 on standing knee x-rays within the last 12 months, and unstable chondral pathology or a meniscal tear with mechanical symptoms that failed at least 6 months of active non-surgical treatment (N45).
- The Ministry may give prior approval for Kellgren-Lawrence grade 3 or 4 when the chart shows significant functional impairment from an unstable flap or degenerative meniscal tear that failed 6 months of non-surgical treatment, and the patient isn't a candidate for realignment or arthroplasty (N46).
- E492 synovectomy is not payable with E494, and E498 is not payable with E494 (N46).
- Not payable for debriding cartilage flaps only to see better during surgery (N46).
- Not payable with E496 for debridement of the meniscal repair attachment site (N47).
- Pre- and post-procedure arthroscopic photos kept in the chart are recommended when E494 is claimed with R687 (N46).
Often billed with
- R687 knee arthroscopy set-up, degenerative disease (N45).
- E495 meniscectomy (N46).
Common rejections
- ADF: OHIP describes this as 'Corresponding procedure invalid, omitted or paid at zero': the add-on was billed without a paid R687 or R699 on the same claim.
Related codes: R687, R699, E495, E498, E492, E489
Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Knee, page N46; arthroscopy payment rules N45.
APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing