Facial prostheses PINs
Last updated on April 13, 2026To print this page, press CTRL+P
Reimbursement for facial prostheses or services is based on the type of product being supplied. Use the relevant PIN on all applications and invoices to ensure accurate billing and payment. Devices and services that require pre-approval are marked with (PA) and those not marked with (PA) do not require pre-approval.
Prosthetic devices may be replaced:
- No sooner than 3 years from the date on the PharmaCare approval letter/form; and
- Only if it is demonstrated that the existing device no longer meets the client’s basic needs.
| PIN | Description | Maximum reimbursement |
|---|---|---|
| 77123177 | ear prosthesis (left) | $6,500 |
| 77123552 | ear prosthesis (left) (PA) | $6,500 |
| 77123189 | ear prosthesis (right) | $6,500 |
| 77123553 | ear prosthesis (right) (PA) | $6,500 |
| 77123501 | nose prosthesis | $6,500 |
| 77123554 | nose prosthesis (PA) | $6,500 |
| 77123153 | ocular prosthesis (left) | $3,000; or $3,100 (extra fitting required) |
| 77123555 | ocular prosthesis (left) (PA) | $3,000; or $3,100 (extra fitting required) |
| 77123141 | ocular prosthesis (right) | $3,000; or $3,100 (extra fitting required) |
| 77123556 | ocular prosthesis (right) (PA) | $3,000; or $3,100 (extra fitting required) |
| 77123567 | orbital prosthesis (left) | $8,500 |
| 77123565 | orbital prosthesis (left) (PA) | $8,500 |
| 77123568 | orbital prosthesis (right) | $8,500 |
| 77123566 | orbital prosthesis (right) (PA) | $8,500 |
PharmaCare covers repair, polish, and retouching services that will significantly extend the life of an ear, eye, nose or orbital prosthesis and delay the need for replacement.
Pre-approval is required for all ocular polish/repair and facial retouching services over $400.
Coverage for facial retouching services is limited to 1 time every 365 days up to a maximum of 2 times per lifetime of the prosthesis. Pre-approval is required if additional coverage is needed.
| PIN | Description | Maximum reimbursement |
|---|---|---|
| 77123165 | ocular polishing/repairs | Maximum $399.99 |
| 77123531 | ocular polishing/repairs (PA) | By approval |
| 77123569 | retouching (ear, nose, and orbital) | Maximum $399.99 |
| 77123570 | retouching (ear, nose, and orbital) (PA) | By approval |