Billing code
X048C — Shoulder - Two Views
Shoulder x-ray, two views
Bill for a two-view x-ray of one shoulder; three or more views are X212.
Watch for: Put the ordering provider's billing number on the claim; outside hospital, bill only the professional component (X048C).
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $0.00 | $22.45 | $0.00 | $8.70 |
- Code
- X048C
- Description
- Shoulder - Two Views
- 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
Shoulder x-ray, two views, one side. Three or more views are X212.
What it covers
X048 is a two-view radiograph of the shoulder (D7). Scapula, clavicle and acromioclavicular joint studies have their own listings (D7). Technical (H) and professional (P) components are claimed separately, and the claiming physician must personally interpret the study (D1, D2).
Billing rules
- Claim the technical component as X048B and the professional component as X048C (D2, GP11).
- Outside a hospital, only the professional component is billable to OHIP (D2, GP11).
- Three or more views is X212; the radiologist may add views when findings are abnormal or the study is insufficient (D2, D7).
- There is no single-view shoulder code: if fewer than the minimum two views are done, the listed fee is reduced by 25% (D2, D7).
- One shoulder per listing; comparison films of the other side initiated by the radiologist are not claimed (D2).
- The technical component is not payable for an in-patient, or a patient admitted to the same hospital within 24 hours for the same condition (GP11).
Common rejections
- ARF: OHIP describes this as 'Missing Physician Referring Number'. The x-ray is done on request and the report goes to the referring provider (D1); add the ordering provider's billing number and resubmit.
Related codes: X212, X049, X045, X046, X050
Source: Schedule of Benefits (July 1, 2026), Diagnostic Radiology, Upper Extremities, Shoulder, page D7; section preamble pages D1 to D2; General Preamble GP11
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