< Billing codes

Billing code

R219A — Phalanx/metacarpal/carpus - Incision And Drainage

Hand bone incision and drainage

Bill R219 for incision and drainage of a finger, metacarpal or carpal bone; finger or wrist joints and tendon sheaths have their own codes.

Watch for: Use the right suffix for each role: R219A surgeon, R219B assistant, R219C anaesthetist.

Code

R219A

Description

Phalanx/metacarpal/carpus - Incision And Drainage

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

Incision and drainage of a phalanx, metacarpal or carpal bone (hand and wrist). Finger or wrist joints and tendon sheaths have their own codes.

What it covers

R219 is incision and drainage of a phalanx, metacarpal or carpus, under Incision and Drainage in the Hand and Wrist part of the Musculoskeletal System Surgical Procedures section (N10). The same group lists sequestrectomy (R218) and saucerization with bone graft (R217); a finger or wrist joint is drained with R409 or R410, and a tendon sheath with R534 (N10).

As a surgical procedure without a Z prefix, the fee includes preparing the patient, the operation, recovery-room care, arranging follow-up and post-operative care until the first post-operative visit (SP1). It is marked #: the fee doesn't include the premises, equipment, supplies and staff for the procedure itself (SP1).

Billing rules

• The major pre-operative visit (where the decision to operate is made) is billed separately; it isn't part of the surgical fee (GP4, SP2).
• The surgeon can't bill a hospital or day-care admission assessment unless it is the major pre-operative visit (SP2).
• Surgical assistant: 6 basic units plus time units (R219B); anaesthetist: 6 basic units plus time units (R219C) (N10, GP85, SP5).
• With other procedures under the same anaesthetic, the major procedure is paid in full and the others at 85% (SP2).
• A later operation for the same condition because of a complication, or for a new condition, is paid in full (SP2).
• Non-elective drainage on a special visit: assessment plus special visit premium plus R219; from 17:00 to 07:00 and on weekends and holidays add E409 or E410 (SP2, GP104).
• Age premiums apply to patients under 16 (GP64).

Often billed with

• A007 intermediate assessment when it is the major pre-operative visit (GP4, SP2).

Common rejections

• V23: OHIP questioned the number of services on the line. Check the count and the suffix for each role: R219A surgeon, R219B assistant, R219C anaesthetist (SP5).

Related codes: R218, R217, R409, R410, R534, Z103, Z101

Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Hand and Wrist, Incision and Drainage, page N10; Surgical Preamble SP1-SP5; General Preamble GP4, GP64, GP85, GP104

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