OHIP Billing Codes

Specialty: Operations Of The Breast

Code	Description	Anes	Asst	Fee
Search a description within this chart
R107	Tumour or tissue for diagnostic biopsy and/or treatment, e.g. carcinoma, fibroadenoma or fibrocystic disease (single or multiple same breast)	6	6	$173.35
	E525 after localization with mammographic wire or radioactive seeds add			$49.00
R108	Mastectomy female (with or without biopsy) simple	7	6	$336.65
	E505 with limited axillary node sampling add			$181.65
R109	Mastectomy, radical or modified radical (with or without biopsy)	7	6	$698.75
R110	Reduction mammoplasty and augmentation mammoplasty (other than postmastectomy breast reconstruction) Reduction mammoplasty (female, to include nipple transplantation or grafting, if rendered) unilateral	7	6	$481.65
R111	Partial mastectomy or wedge resection for treatment of breast disease, with or without biopsy, e.g. carcinoma or extensive fibrocystic disease	7	6	$274.80
	E505 with limited axillary node sampling add			$181.65
	E525 after localization with mammographic wire or radioactive seeds add			$49.00
	E546 with axillary node dissection up to the level of the axillary vein add			$396.55
R112	Augmentation mammoplasty unilateral	7	6	$357.05
R114	Revision of breast mound	7	6	$234.95
R117	Mastectomy female (with or without biopsy) subcutaneous with nipple preservation	7	6	$279.45
	E505 with limited axillary node sampling add			$181.65
R118	Breast skin reconstruction by local flaps or grafts, includes Wise pattern skin flaps and deepithelialized skin flaps	6	6	$413.75
	E513 Breast mound creation by soft tissue, includes flap insetting and shaping for autogenous reconstruction add			$303.50
	E529 with breast mound creation by prosthesis add			$104.50
R119	Postmastectomy breast reconstruction Breast mound creation by prosthesis as sole procedure	7	6	$357.05
Not finding what you’re looking for? Dr.Bill is built on a team of medical billing experts. We are here to help out with daily billing needs or just to answer your questions. Talk to an agent
R120	Nippleareola reconstruction by grafts and/or flaps	7	6	$306.05
R142	Nippleareola tattooing unilateral	0		$178.50
R143	Contralateral balancing mastopexy or reduction, to include nipple transplantation or grafting, if rendered	6	6	$481.65
R144	Contralateral balancing augmentation mammoplasty	6	6	$357.05
R146	Mastectomy male (benign) simple	7	6	$181.05
R147	Mastectomy male (benign) subcutaneous with nipple preservation	7	6	$279.45
R148	Mastectomy male Unilateral for treatment of pathological male breast disease (with or without biopsy), e.g. carcinoma simple	7	6	$279.45
	E505 with limited axillary node sampling add			$181.65
R149	Mastectomy male Unilateral for treatment of pathological male breast disease (with or without biopsy), e.g. carcinoma subcutaneous with nipple preservation	7	6	$279.45
	E505 with limited axillary node sampling add			$181.65
R156	Breast mound creation by insertion of tissue expander, includes creation of submuscular pocket	6	6	$433.55
	E514 Immediate breast reconstruction following mastectomy, to R125, R064, R156, R008 or R155 add			$204.00
R505	Ankle Metatarsal/phalangeal	6	6	$147.70
Z135	Open capsulotomy with or without replacement of breast prosthesis	7	6	$199.90
Z139	Aspiration of cyst one or more	0		$37.95
Z140	Drainage of intramammary abscess or haematoma Single or multiloculated local anaesthetic	0		$33.65
Z141	Needle biopsy one or more	0		$37.95
	E542 when performed outside hospital add			$11.80
Z142	Removal of breast prosthesis	7	6	$153.00
Z143	Needle biopsy large core breast biopsy (14 gauge or larger bore needle)	0		$135.40
Z182	Breast capsulectomy	7	6	$260.20
Z740	Drainage of intramammary abscess or haematoma Single or multiloculated generalanaesthetic	6		$136.50

The information presented on this page is general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBCx or its affiliates.