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Billing code

R687A — Knee arthroscopy set-up – degenerative knee disease

Knee arthroscopy, degenerative knee

Bill R687 as the set-up fee for knee arthroscopy in degenerative knee disease, including synovial biopsy or plica trimming.

Watch for: Only E494, E495 and E476 are payable with it, and E494 and E495 need the x-ray and failed-treatment criteria or prior approval.

Code

R687A

Description

Knee arthroscopy set-up – degenerative knee disease

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

Set-up fee for knee arthroscopy in degenerative knee disease, including synovial biopsy or plica trimming. Procedures are added with E-codes.

What it covers

R687 is the knee arthroscopy set-up for degenerative disease of the knee, and includes synovial biopsy and/or resection or trimming of plica when rendered (N45).

Non-degenerative disorders or an acutely locked knee use R699 instead (N45).

Billing rules

• Only E494, E495 and E476 from the arthroscopy E-codes are payable with R687 (N45).
• 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).
• E476 (loose body or screw removal) needs a loose body causing mechanical symptoms or a symptomatic loose screw (N45).
• R687 is payable for any degenerative patient when diagnostic arthroscopy is needed before or with a proximal tibial or distal femoral osteotomy (N45).
• Uninsured for lavage alone for osteoarthritis, when the rule 5 criteria aren't met and no other E-code is needed, or when prior approval is denied (N45).
• A Knee-section procedure done arthroscopically can be billed with R687 unless it is part of R699 or an R699 E-code (N45).
• A pre-operative consultation before arthroscopic surgery under local anaesthesia and/or IV sedation is payable only if the chart shows it was medically necessary (GP18).

Often billed with

• E494 debridement of degenerative cartilage (N46).
• E495 meniscectomy for symptomatic tear (N46).
• E476 removal of symptomatic loose body or screw (N46).

Related codes: R699, E494, E495, E476, E498, R417

Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Knee, page N45.

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