Integumentary system surgical procedures OHIP billing codes


Incision

Code Description Amount Ans Units Assist Units
Z101 Abscess or haematoma - Local anaesthetic - subcutaneous - one $25.75 N/A N/A
Z173 Abscess or haematoma - Local anaesthetic - subcutaneous - two $30.35 N/A N/A
Z174 Abscess or haematoma - Local anaesthetic - subcutaneous - three or more $40.80 N/A N/A
Z104 Abscess or haematoma - Local anaesthetic - subcutaneous - perianal $20.10 N/A N/A
Z106 Abscess or haematoma - Local anaesthetic - subcutaneous - ischiorectal or pilonida $44.35 N/A N/A
Z103 Abscess or haematoma - Local anaesthetic - subcutaneous - palmar or plantar spaces $44.35 N/A N/A
E542 - , when performed outside hospital add $0.00 N/A N/A
Z102 Abscess or haematoma - General anaesthetic - subcutaneous - one $44.35 6 N/A
Z172 Abscess or haematoma - General anaesthetic - subcutaneous - two or more $66.00 7 N/A
Z105 Abscess or haematoma - General anaesthetic - subcutaneous - perianal $66.00 6 N/A
Z107 Abscess or haematoma - General anaesthetic - subcutaneous - ischiorectal or pilonidal $108.00 6 N/A
Z108 Abscess or haematoma - General anaesthetic - subcutaneous - palmar or plantar spaces $72.00 6 N/A
Z114 Foreign body removal - local anaesthetic $25.25 N/A N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z115 Foreign body removal - general anaesthetic $88.80 6 6
Z100 Foreign body removal - general anaesthetic: complicated $0.00 7 6
Z227 Foreign body removal - Intramuscular abscess or haematoma $101.65 6 N/A
Z118 Foreign body removal - Aspiration of superficial lump for cytology $28.25 N/A N/A
Z116 Biopsy(ies) - any method, when sutures are used $29.60 N/A N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z113 Biopsy(ies) - any method, when sutures are not used $29.60 N/A N/A
Z155 Biopsy(ies) extensive, complicated or requiring general anaesthetic when sole procedure $0.00 N/A N/A
Z245 Biopsy for malignant hyperthermia, three or more $152.85 10 N/A
Z141 Needle biopsy - one or more $37.20 N/A N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z143 Needle biopsy - large core breast biopsy (14 gauge or larger bore needle) $132.75 N/A N/A
Z139 Aspiration of cyst - one or more $37.20 N/A N/A
Z140 Drainage of intramammary abscess or haematoma - Single or multiloculated local anaesthetic $33.00 N/A N/A
Z740 Drainage of intramammary abscess or haematoma - Single or multiloculated general anaesthetic $75.00 6 N/A

Excision

Code Description Amount Ans Units Assist Units
R107 Tumour or tissue for diagnostic biopsy and/or treatment, e.g. carcinoma, fibroadenoma or fibrocystic disease (single or multiple same breast) $169.95 6 6
E525 - Tumour or tissue for diagnostic biopsy and/or treatment, e.g. carcinoma, fibroadenoma or fibrocystic disease (single or multiple same breast) after mammographic wire localization, to R107 . . . Add $41.55 N/A N/A
R111 Partial mastectomy or wedge resection for treatment of breast disease, with or without biopsy, e.g. carcinoma or extensive fibrocystic disease $269.40 7 6
E525 - Tumour or tissue for diagnostic biopsy and/or treatment, e.g. carcinoma, fibroadenoma or fibrocystic disease (single or multiple same breast) after mammographic wire localization, to R107 . . . Add $41.55 N/A N/A
E546 - Partial mastectomy or wedge resection for treatment of breast disease, with or without biopsy, e.g. carcinoma or extensive fibrocystic disease with axillary node dissection up to the level of the axillary vein, to R111 . . . add $388.75 N/A N/A
E505 - Partial mastectomy or wedge resection for treatment of breast disease, with or without biopsy, e.g. carcinoma or extensive fibrocystic disease with limited axillary node sampling, to R111 . . . add $178.05 N/A N/A
R108 Mastectomy - female (with or without biopsy) - simple $330.00 7 6
R117 Mastectomy - female (with or without biopsy) - subcutaneous with nipple preservation $273.95 7 6
E505 - Partial mastectomy or wedge resection for treatment of breast disease, with or without biopsy, e.g. carcinoma or extensive fibrocystic disease with limited axillary node sampling, to R111 . . . add $178.05 N/A N/A
R109 Mastectomy, radical or modified radical (with or without biopsy) $685.00 7 6
R146 Mastectomy - male (benign) - simple $177.50 7 6
R147 Mastectomy - male (benign) - subcutaneous with nipple preservation $273.95 7 6
R148 Mastectomy - male - Unilateral for treatment of pathological male breast disease (with or without biopsy), e.g. carcinoma - simple $273.95 7 6
R149 Mastectomy - male - Unilateral for treatment of pathological male breast disease (with or without biopsy), e.g. carcinoma - subcutaneous with nipple preservation $273.95 7 6
E505 - Partial mastectomy or wedge resection for treatment of breast disease, with or without biopsy, e.g. carcinoma or extensive fibrocystic disease with limited axillary node sampling, to R111 . . . add $178.05 N/A N/A
S093 Enucleation of benign oesophageal tumour $584.15 N/A N/A

Plastic Surgery Procedures

Code Description Amount Ans Units Assist Units
R150 Plastic Surgery Procedures - Very Minor - The minimum benefit for each would be as follows: $92.30 6 N/A
R151 Plastic Surgery Procedures - Minor - The minimum benefit for each would be as follows: $140.25 6 6
R152 Plastic Surgery Procedures - Intermediate - The minimum benefit for each would be as follows: $259.20 7 6
R153 Plastic Surgery Procedures - Major - The minimum benefit for each would be as follows: $388.00 7 6
R154 Plastic Surgery Procedures - Extensive Major - The minimum benefit for each would be as follows: $568.95 6 6
Z132 Insertion of tissue expander $304.10 7 6
E527 - additional expander, same incision . . . Add $58.95 N/A N/A
E528 - additional expander, different incision . . . Add $258.50 N/A N/A
Z094 Removal tissue expander injection port when sole procedure - general anaesthetic $75.45 6 6
Z095 Removal tissue expander injection port when sole procedure - local anaesthetic $37.70 N/A N/A
Z137 Percutaneous inflation of first tissue expander $23.05 N/A N/A
E541 - each additional expander (to a maximum of 3) $11.55 N/A N/A
Z138 Replacement of tissue expander by permanent prosthesis $195.85 7 N/A

Scar Revision Any Method Of Closure

Code Description Amount Ans Units Assist Units
R021 Scar Revision - Up to 2.5 cm - face or neck $115.60 6 6
R026 Scar Revision - Up to 2.5 cm - other areas $77.35 6 6
R022 Scar Revision - 2.6 cm to 5 cm - face or neck $194.85 6 6
R027 Scar Revision - 2.6 cm to 5 cm - other areas $130.10 6 6
R023 Scar Revision - 5.1 cm to 10 cm - face or neck $277.90 7 6
R028 Scar Revision - 5.1 cm to 10 cm - other areas $185.60 6 6
R017 Scar Revision - Greater than 10 cm - face or neck $417.05 7 6
R029 Scar Revision - Greater than 10 cm - other areas $288.20 7 6

Finger Or Toe Nail

Code Description Amount Ans Units Assist Units
Z110 Extensive debridement of onychogryphotic nail involving removal of multiple laminae $17.45 N/A N/A
Z128 Simple, partial or complete, nail plate excision requiring anaesthesia - one $33.10 6 N/A
Z129 Simple, partial or complete, nail plate excision requiring anaesthesia - multiple $35.70 6 N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z130 Radical, including destruction of nail bed - one $62.75 6 N/A
Z131 Radical, including destruction of nail bed - multiple $82.65 6 N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
R089 Webbed fingers and toes - Webbed fingers one web space $400.00 6 6
R090 Webbed fingers and toes - Webbed toes one web space $250.00 7 6

Free Island Flaps

Code Description Amount Ans Units Assist Units
R013 Free jejunum artery and vein for transplantation $338.85 10 10
R014 Preparation of microvascular recipient site for free jejunum artery and vein $925.85 10 10
R016 Preparation of microvascular recipient site for jejunum artery and vein immediately following ablative surgery, and when recipient vessels are in site of the ablation $544.95 10 10
R015 Transplantation of free jejunum artery and vein with microvascular anastomosis $925.85 10 10
R064 Elevation of free island skin and subcutaneous flap and closure of defect $874.60 10 10
R065 Preparation of microvascular recipient site for free island skin subcutaneous flap $925.85 10 10
R055 Preparation of microvascular recipient site for free island flap and subcutaneous flap immediately following ablative surgery and when recipient vessels are in site of the ablation $544.95 10 10
R066 Transplantation of free island skin and subcutaneous flap with microvascular anastomosis(es) $925.85 10 10
R067 Elevation of innervated free island skin and subcutaneous flap and closure of defect $1,028.20 10 10
R068 Preparation of microvascular recipient site for innervated free island skin and subcutaneous flap $1,028.20 10 10
R056 Preparation of microvascular recipient site for innervated free island skin and subcutaneous flap immediately following ablative surgery and when recipient vessels are in the site of ablation $605.15 10 10
R069 Transplantation of innervated free island skin and subcutaneous flap with microvascular anastomosis(es) and nerve repair $961.60 10 10
R125 Elevation of free island skin and muscle flap and closure of defect $874.60 10 10
R126 Preparation of microvascular recipient site for free island skin and muscle flap $925.85 10 10
R122 Preparation of microvascular recipient site for free island skin and muscle flap immediately following ablative surgery and when recipient vessels are in the site of the ablation $544.95 10 10
R127 Transplantation of free island skin and muscle flap with microvascular anastomosis(es) $874.60 10 10
R128 Elevation of free island muscle flap with tendon and nerve, and closure of defect . $1,183.50 10 10
R129 Preparation of microvascular recipient site for muscle, tendon and nerve anastomosis(es) $1,183.20 10 10
R123 Preparation of microvascular recipient site for muscle, tendon and nerve anastomosis(es) immediately following ablative surgery and when recipient vessels are in site of the ablation $696.40 10 10
R130 Transplantation of free island muscle flap with tendon, nerve and microvascular anastomosis(es) $1,183.50 10 10
R131 Elevation of free island bone flap and closure of defect $874.60 10 10
R132 Preparation of microvascular recipient site for free island bone flap $925.85 10 10
R124 Preparation of microvascular recipient site for free island bone flap immediately following ablative surgery and when recipient vessels are in the site of the ablation $544.95 10 10
R133 Transplantation of free island bone flap with microvascular anastomosis(es) and bone fixation $1,028.20 10 10
R134 Elevation of free island skin and bone flap and closure of defect $1,048.60 10 10
R135 Preparation of microvascular recipient site for free island skin and bone flap $1,048.60 10 10
R140 Preparation of microvascular recipient site for free island skin and bone flap immediately following ablative surgery and when recipient vessels are in the site of the ablation $617.10 10 10
R136 Transplantation of free island skin and bone flap with microvascular anastomosis(es) and bone fixation $1,048.60 10 10
R137 Elevation of free toe or finger and closure of defect $1,048.60 10 10
R138 Preparation of microvascular recipient site for free toe or finger transplant $1,048.60 10 10
R141 Preparation of microvascular recipient site for free toe or finger transplant immediately following ablative surgery and when recipient vessels are in the site of the ablation $617.10 10 10
R139 Transplantation of free island toe or finger with microvascular anastomosis(es) and tendon nerve and bone repair $1,233.75 10 10
R025 Revision of free island flaps $0.00 10 10
R106 Skin flaps and grafts other $0.00 N/A N/A

Skin Grafts

Code Description Amount Ans Units Assist Units
R084 Split thickness grafts - Very minor, very small areas, e.g. trauma $92.30 7 N/A
R085 Split thickness grafts - Minor, medium sized areas, e.g. small or skin ulcer, breast, etc $140.25 6 6
R086 Split thickness grafts - Intermediate, large areas, e.g. trunk, arms, legs $259.10 7 6
R087 Split thickness grafts -Major, complex areas, e.g. face, neck, hands $388.00 7 6
R088 Split thickness grafts -Extensive major, very large area(s) $567.95 6 6
R092 Full thickness grafts - Minor less than 1 cm average diameter $116.65 7 N/A
R093 Full thickness grafts - Intermediate 1 cm to 5 cm average diameter $178.90 7 6
R083 Full thickness grafts - Major over 5 cm $280.15 7 6
R091 Full thickness grafts - Complex eyelid, nose, lip, face $263.95 7 6
R057 Appendage or tissue revascularization involving microanastomosis with or without micro neuroanastomosis $0.00 N/A N/A
R058 Revision of appendage or tissue revascularization involving microanastomosis with or without micro neuroanastomosis $0.00 N/A N/A
R847 Stasis ulcer - with skin graft per leg $195.85 7 6
R845 Stasis ulcer - multiple ligation and skin graft per leg $341.55 6 6
R061 Neurovascular island transfer - Minor, e.g. finger tip $140.25 6 6
R062 Neurovascular island transfer - Intermediate, e.g. finger to thumb transfer $259.20 6 6
R063 Neurovascular island transfer - Major, e.g. foot to heel $430.85 6 6

Skin Flaps

Code Description Amount Ans Units Assist Units
R011 Advancement flaps - Defect 2.1 to 5 cm - face, neck or scalp $89.85 6 6
R002 Advancement flaps - Defect 2.1 to 5 cm - other areas $67.40 6 6
R012 Advancement flaps - Defect 5.1 to 10 cm - face, neck or scalp $247.15 6 6
R003 Advancement flaps - Defect 5.1 to 10 cm - other areas $161.75 6 6
R004 Advancement flaps - Defect more than 10 cm such as thoracic abdominal flap $242.70 7 6
R045 Rotations, transpositions, Z-plasties - Defect less than 2 cm average diameter - face, neck or scalp $203.70 6 6
R072 Rotations, transpositions, Z-plasties - Defect less than 2 cm average diameter - other areas $133.40 7 6
R046 Rotations, transpositions, Z-plasties - Defect 2.1 to 5 cm average diameter - face, neck or scalp $335.15 6 6
R075 Rotations, transpositions, Z-plasties - Defect 2.1 to 5 cm average diameter - other areas $223.35 6 6
R047 Rotations, transpositions, Z-plasties - Defect 5.1 to 10 cm average diameter - face, neck or scalp $477.45 7 6
R073 Rotations, transpositions, Z-plasties - Defect 5.1 to 10 cm average diameter - other areas $318.45 7 6
R076 Rotations, transpositions, Z-plasties - Defect more than 10 cm average diameter - face, neck or scalp $709.90 7 6
R074 Rotations, transpositions, Z-plasties - Defect more than 10 cm average diameter -other areas $477.85 7 6
R070 Pedicle flaps - Small/Intermediate, e.g. cross finger, cervical finger $293.75 7 6
R071 Pedicle flaps - Small/Intermediate, e.g. cross finger, cervical finger - each subsequent stage $223.35 6 6
R080 Pedicle flaps - Large, e.g. cross leg, deltopectoral, forehead $416.30 6 6
R078 Pedicle flaps - Large, e.g. cross leg, deltopectoral, forehead - each subsequent stage $311.45 7 6
E069 - Pedicle flaps preparation of a contracted recipient site, to R070 or R080 . . . add $134.75 N/A N/A
R101 Pedicle flaps - Delay, Small/Intermediate flap $132.45 7 6
R100 Pedicle flaps - Delay, major flap $291.90 6 6
R005 Myocutaneous, myogenous or fascia-cutaneous flaps - Sternomastoid, tensor fascia lata, gluteus maximus, gracilis, sartorius, rectus femoris, gastrocnemius (medial and lateral), trapezius $545.00 6 6
R006 Myocutaneous, myogenous or fascia-cutaneous flaps - Pectoralis major $734.95 6 6
R155 Myocutaneous, myogenous or fascia-cutaneous flaps - Latissimus dorsi or unilateral rectus abdominus $734.95 6 6
R008 Myocutaneous, myogenous or fascia-cutaneous flaps - Lower transverse rectus abdominus flap $984.55 8 6
Z196 Myocutaneous, myogenous or fascia-cutaneous flaps - Repair of abdominal defect - different surgeon $377.65 N/A N/A
E523 - Myocutaneous, myogenous or fasciacutaneous flaps Repair of abdominal defect same surgeon, to other procedure . . . Add $321.00 N/A N/A
R009 Myocutaneous, myogenous or fascia-cutaneous flaps - Myocutaneous osseous flaps e.g. pectoralis major myocutaneous flap with rib graft, trapezius flap with scapula spine $783.40 8 6
R007 Myocutaneous, myogenous or fascia-cutaneous flaps - Other $0.00 N/A N/A

Necrotizing Fasciitis

Code Description Amount Ans Units Assist Units
R698 Debridement, excision and flap and/or graft closure - in Operating Room - Debridement, excision and flap and/or graft closure for necrotizing fasciitis . . . Per unit $100.00 10 6

Burns

Code Description Amount Ans Units Assist Units
R030 Minor burns $0.00 6 6
R038 Moderate burns $0.00 10 6
R039 Major burns $0.00 15 8
Z180 Resuscitation - Major Burn, Initial Care - first day $106.25 N/A N/A
Z181 Resuscitation - Major Burn, Initial Care - continuing care, 2nd to 4th day inclusive, per day $53.10 N/A N/A
R691 Debridement, excision and/or grafting - in Operating Room - Minor burn . . . Per unit $75.00 N/A N/A
R692 Debridement, excision and/or grafting - in Operating Room - Moderate burn . . . Per unit $87.50 N/A N/A
R693 Debridement, excision and/or grafting - in Operating Room - Major burn . . . Per Unit $100.00 N/A N/A
R660 Burn debridement and excision - outside Operating Room - hand each digit $28.90 N/A N/A
R661 Burn debridement and excision - outside Operating Room - dorsum, palm each $47.95 N/A N/A
R662 Burn debridement and excision - outside Operating Room - nose, cheek, lip, ear, forehead, scalp, neck, eyelid each $28.90 N/A N/A
R637 Debridement and excision, per % of total body treated other than hand, head or neck $29.65 N/A N/A
R690 Skin allograft procurement - for banking purposes, per % of total body harvested, other than hand, head or neck $17.25 7 7

Wound And Ulcer Debridement

Code Description Amount Ans Units Assist Units
Z080 Debridement of wound(s) and/or ulcer(s) extending into subcutaneous tissue - one $20.00 N/A N/A
Z081 Debridement of wound(s) and/or ulcer(s) extending into subcutaneous tissue - two $30.00 N/A N/A
Z082 Debridement of wound(s) and/or ulcer(s) extending into subcutaneous tissue - three $45.00 N/A N/A
Z083 Debridement of wound(s) and/or ulcer(s) extending into subcutaneous tissue - four or more $60.00 N/A N/A
Z084 Debridement of wound(s) and/or ulcer(s) extending into any of the following structures: tendon, ligament, bursa and/or bone - one $60.00 N/A N/A
Z085 Debridement of wound(s) and/or ulcer(s) extending into any of the following structures: tendon, ligament, bursa and/or bone - two or more $90.00 N/A N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A

Malignant Lesions Including Biopsy Of Each Lesion Single Or Multiple Sites

Code Description Amount Ans Units Assist Units
R048 Face or neck - Simple excision - single lesion $92.15 6 6
R049 Face or neck - Simple excision - two lesions $139.20 7 6
R050 Face or neck - Simple excision - three or more lesions $233.00 7 6
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
R094 Other areas - Simple excision - single lesion $58.15 7 6
R040 Other areas - Simple excision - two lesions $95.70 6 6
R041 Other areas - Simple excision - three or more lesions $191.40 7 6
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
R010 Malignant melanoma - wide excision in any area and must include > 1 cm margins and layered closure $124.10 7 6
E540 - if excision is performed in hospital for tumour free margin with frozen section, to excision or repair fees . . . Add 25% $0.00 N/A N/A
R018 Face or neck - Curettage, electrodesiccation or cryosurgery - single lesion $68.55 6 6
R019 Face or neck - Curettage, electrodesiccation or cryosurgery - two lesions $112.90 7 6
R020 Face or neck - Curettage, electrodesiccation or cryosurgery - three or more lesions $225.75 6 6
R031 Other areas - Curettage, electrodesiccation or cryosurgery - single lesion $55.05 6 6
R032 Other areas - Curettage, electrodesiccation or cryosurgery - two lesions $90.70 7 6
R033 Other areas - Curettage, electrodesiccation or cryosurgery - three or more lesions $181.55 6 6
R051 Laser surgery on Group 1 4, premalignant and malignant lesions $0.00 N/A N/A
Z117 Chemical and/or cryotherapy treatment of skin lesions - Chemical and/or cryotherapy treatment, one or more lesions $11.65 N/A N/A

Excision Of Pre Malignant Lesions Including Biopsy Of Each Lesion – Single Or Multiple Sites

Code Description Amount Ans Units Assist Units
R160 Face or Neck - Simple excision - single lesion $53.20 6 6
R161 Face or Neck - Simple excision - two lesions $87.40 6 6
R162 Face or Neck - Simple excision - three or more lesions $174.75 6 6
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
R163 Other Areas - Simple excision - single lesion $43.60 6 6
R164 Other Areas - Simple excision - two lesions $71.80 6 6
R165 Other Areas - Simple excision - three or more lesions $143.55 6 6
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z119 Cryotherapy treatment of at least 5 premalignant actinic keratosis lesions on the same day, not to include freezethaw cycles $29.00 N/A N/A

Excision (With Or Without Biopsy): Lesions Single Or Multiple Sites

Code Description Amount Ans Units Assist Units
Z156 Group 1 - e.g. keratosis, pyogenic granuloma - Removal by excision and suture - single lesion $0.00 6 20
Z157 Group 1 - e.g. keratosis, pyogenic granuloma - Removal by excision and suture - two lesions $26.50 6 N/A
Z158 Group 1 - e.g. keratosis, pyogenic granuloma - Removal by excision and suture - three or more lesions $44.25 6 N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z159 Group 1 - e.g. keratosis, pyogenic granuloma - Removal by electrocoagulation and/or curetting - single lesion $10.55 6 N/A
Z160 Group 1 - e.g. keratosis, pyogenic granuloma - Removal by electrocoagulation and/or curetting - two lesions $15.85 6 N/A
Z161 Group 1 - e.g. keratosis, pyogenic granuloma - Removal by electrocoagulation and/or curetting - three or more lesions $26.20 6 N/A
Z162 Group 2 - nevus - Removal by excision and suture - single lesion $0.00 6 20
Z163 Group 2 - nevus - Removal by excision and suture - two lesions $26.50 6 N/A
Z164 Group 2 - nevus - Removal by excision and suture - three or more lesions $44.25 6 N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z165 Group 2 - nevus - Congenital (extensive) $0.00 N/A N/A
Z122 Group 3 - cyst, haemangioma, lipoma - Face or neck Local anaesthetic - single lesion $38.50 N/A N/A
Z123 Group 3 - cyst, haemangioma, lipoma - Face or neck Local anaesthetic - two lesions $67.80 N/A N/A
Z124 Group 3 - cyst, haemangioma, lipoma - Face or neck Local anaesthetic - three or more lesions $78.00 N/A N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z145 Group 3 - cyst, haemangioma, lipoma - Face or neck General anaesthetic - single lesion $65.35 6 6
Z146 Group 3 - cyst, haemangioma, lipoma - Face or neck General anaesthetic - two lesions $98.55 6 6
Z147 Group 3 - cyst, haemangioma, lipoma - Face or neck General anaesthetic - three or more lesions $162.55 6 6
Z148 Group 3 - cyst, haemangioma, lipoma - Face or neck General anaesthetic - extensive or massive $0.00 7 6
Z125 Group 3 - cyst, haemangioma, lipoma - Other areas - Local anaesthetic - single lesion $32.00 N/A N/A
Z126 Group 3 - cyst, haemangioma, lipoma - Other areas - Local anaesthetic - two lesions $45.00 N/A N/A
Z127 Group 3 - cyst, haemangioma, lipoma - Other areas - Local anaesthetic - three or more lesions $60.00 N/A N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z149 Group 3 - cyst, haemangioma, lipoma - Other areas General anaesthetic - single lesion $50.00 6 6
Z150 Group 3 - cyst, haemangioma, lipoma - Other areas General anaesthetic - two lesions $98.55 6 6
Z151 Group 3 - cyst, haemangioma, lipoma - Other areas General anaesthetic - three or more lesions $98.55 6 6
Z152 Group 3 - cyst, haemangioma, lipoma - Other areas General anaesthetic -extensive or massive $0.00 6 6
Z096 Group 4 - other lesions - Lipoma 5 to 10 cm $80.00 6 6
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z097 Group 4 - other lesions - Lipoma over 10 cm $160.00 6 6
R034 Group 4 - other lesions - Congenital dermoid cyst adult $124.40 6 6
R043 Group 4 - other lesions - Congenital dermoid cyst adult - infant or child $201.10 6 6
R042 Group 4 - other lesions - Congenital dermoid cyst adult - midline, e.g. nasal $272.80 6 6
R037 Group 4 - other lesions - Giant cell tumour $200.00 6 6
R035 Group 4 - other lesions - Pilonidal cyst - simple excision or marsupialization $200.00 6 N/A
R054 Group 4 - other lesions - Pilonidal cyst - simple excision or marsupialization, if patient's BMI greater than 40 $250.00 6 6
R036 Group 4 - other lesions - Pilonidal cyst - excision and skin shift $280.00 6 6
R059 Group 4 - other lesions - Inguinal, perineal or axillary skin and sweat glands for hyperhydrosis and/or hydradenitis - unilateral $248.80 6 6
R060 Inguinal, perineal or axillary skin and sweat glands for hyperhydrosis and/or hydradenitis - with skin graft(s) or rotation flap(s) $377.90 7 6

Repair

Code Description Amount Ans Units Assist Units
R119 Post-mastectomy breast reconstruction - Breast mound creation by prosthesis as sole procedure $350.00 7 6
R118 Breast skin reconstruction by local flaps or grafts, includes Wise pattern skin flaps and deepithelialized skin flaps $405.60 6 6
E529 - with breast mound creation by prosthesis, to R118 . . . add $102.45 N/A N/A
R156 Breast mound creation by insertion of tissue expander, includes creation of submuscular pocket $425.00 6 6
E513 - breast mound creation by soft tissue, includes flap insetting and shaping for autogenous reconstruction, to R118, R125, R064, R008 or R155 . . . Add $297.50 N/A N/A
E514 - immediate breast reconstruction following mastectomy, to R125, R064, R156, R008 or R155 . . . add $200.00 N/A N/A
R114 Revision of breast mound $230.30 7 6
R120 Nippleareola reconstruction by grafts and/or flaps $300.00 7 6
R142 Nippleareola tattooing unilateral $175.00 N/A N/A
R143 Contralateral balancing mastopexy or reduction, to include nipple transplantation or grafting, if rendered $472.15 6 6
R144 Contralateral balancing augmentation mammoplasty $350.00 6 6
R110 Reduction mammoplasty and augmentation mammoplasty (other than post-mastectomy breast reconstruction) - Reduction mammoplasty (female, to include nipple transplantation or grafting, if rendered) unilateral $472.15 7 6
R112 Augmentation mammoplasty unilateral $350.00 7 6
Z142 Removal of breast prosthesis $150.00 7 6
Z135 Open capsulotomy with or without replacement of breast prosthesis $195.95 7 6
Z182 Breast capsulectomy $255.05 7 6
E554 - synovectomy requiring a minimum of 30 minutes to resect add $175.00 N/A N/A
E551 - Autogenous separate incision . . . Add $86.30 N/A N/A
E552 - Autogenous same incision . . . Add $58.45 N/A N/A

Other

Code Description Amount Ans Units Assist Units
R081 MOHS Micrographic Surgery - Initial cut, including debulking $315.45 7 6
E524 - MOHS Micrographic Surgery one or more additional cuts, to R081 . . . Add $273.45 N/A N/A
Z176 Repair of lacerations - up to 5 cm $20.00 6 N/A
Z154 Repair of lacerations - up to 5 cm if on face and/or requires tying of bleeders and/or closure in layers $35.90 6 N/A
Z175 Repair of lacerations - 5.1 to 10 cm $35.90 6 N/A
Z177 Repair of lacerations - 5.1 to 10 cm if on face and/or requires tying of bleeders and/or closure in layers $71.30 6 N/A
Z179 Repair of lacerations - 10.1 to 15 cm $50.40 6 N/A
Z190 Repair of lacerations - 10.1 to 15 cm if on face and/or requires tying of bleeders and/or closure in layers $101.45 6 N/A
Z191 Repair of lacerations - more than 15.1 cm other than face $77.30 6 N/A
Z192 Repair of lacerations - more than 15.1 cm on face $154.95 7 N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
E530 - Repair of lacerations if inhalation general anaesthesia (other than 50% N2O/O2 mixture) is used, when suture of laceration is sole procedure . . . Add $50.40 N/A N/A
E531 - Repair of lacerations if extensive debridement is required . . . Add $0.00 N/A N/A
R024 Repair of lacerations - Acute laceration earlobe, unilateral $100.65 N/A N/A
UVC Repair of lacerations - Removal of sutures only $0.00 N/A N/A
E208 - Peritomy (Gunderson conjunctival flap) $225.00 6 N/A
Z187 Complex laceration repair, face $92.30 N/A N/A
Z188 Complex laceration repair, anatomical area other than face, (except digit, zone 1 repair) $92.30 N/A N/A
Z189 Complex repair, digit, zone 1 repair, without soft tissue loss, per digit $92.30 N/A N/A
R525 Muscle repair - Simple muscle repair(s) to include repair of involved skin $88.60 7 6
R528 Muscle repair - Complex $0.00 6 6
E540 - Malignant melanoma wide excision in any area and must include > 1 cm margins and layered closure if excision is performed in hospital for tumour free margin with frozen section, to excision or repair fees . . . Add 25% $0.00 N/A N/A