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Billing code

F096A — Femur fracture – open reduction

Femur fracture, open reduction

Bill F096 for open reduction of a femur fracture, including an intramedullary nail with proximal and distal locking screws.

Watch for: F096 can't be billed with F093 for fractures below the intertrochanteric region of the same femur; OHIP rejects the pair.

Code

F096A

Description

Femur fracture – open reduction

FHO+ basket

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

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Open reduction of a femur fracture, including an intramedullary nail with proximal and distal locking screws.

What it covers

F096 is open reduction of a femur fracture (N43). It includes an intramedullary nail with proximal and distal locking screws if used (N43).

A diaphyseal or metaphyseal distal femur fracture with intra-articular extension is F093; closed reduction with external fixation, skeletal traction or a spica cast in a child is F095 (N43).

Billing rules

• Open reduction means treating the fracture or dislocation by closed intramedullary fixation or by an operation that exposes it; the fee includes fixation by internal or external devices (N1).
• F096 is not payable with F093 for fractures below the intertrochanteric region of the same femur (N43).
• The major pre-operative visit (the consultation or assessment where you decide to treat) may be billed in addition to the fracture or dislocation fee (N1, SP2).
• Multiple fractures or dislocations: the major one is paid at 100% and each other one at 85% (N1).
• If after-care is transferred to another physician, the surgeon who did the open reduction claims 80% of the fee (N2).
• Non-elective and started after hours: add E409 (+50%, weekday evenings and weekend/holiday days and evenings) or E410 (+75%, nights 00:00–07:00) (GP103–GP104, SP2).
• 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).
• Age premiums of 10% to 30% apply for patients under 16 (GP64).

Common rejections

• ADH: OHIP describes this as 'Cannot be billed together': F096 isn't payable with F093 below the intertrochanteric region of the same femur (N43).

Related codes: F093, F095, F094, F021, R268

Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Femur, page N43. Fracture and dislocation rules N1–N2.

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