What is OHIP billing code R046?

R046 is "Rotations, transpositions, Z-plasties - face, neck or scalp - Defect 2.1 to 5 cm average diameter", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R046 pay?

The current OHIP fee for R046 is $335.15, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R046 to OHIP?

R046 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R046 claims against the Schedule of Benefits rules before submission.

What codes are related to R046?

Codes related to R046 in the Schedule of Benefits include Z427, R045, R072, R075, R047, R073, R076, R074.

All codes

R046

R046 – Rotations, transpositions, Z-plasties - face, neck or scalp - Defect 2.1 to 5 cm average diameter

OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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A surgical procedure for the repair of a defect on the face, neck or scalp with an average diameter of 2.1 to 5 cm. The repair is performed using rotation flaps, transposition flaps, or Z-plasties. The service includes necessary undermining. As noted in the Preamble to Skin Flaps and Grafts on page , additional procedures other than skin grafting (e.g., tendon grafts, inlay grafts) are payable in addition to the skin flap or graft service.

When to Use

Use for the repair of a defect on the face, neck, or scalp measuring 2.1 to 5 cm using a rotation flap, transposition flap, or Z-plasty technique.
Use when the excision of a lesion is performed as part of the same procedure, as R046 is intended to include the excision of the lesion if it is the technique of closure.

Common Pitfalls

Billing R046 for defects smaller than 2.1 cm or larger than 5 cm, which requires using R045 or R047 respectively.
Attempting to bill a separate excision code (e.g., R002-R004) in addition to R046; the fee for R046 includes the excision of the lesion.
Failing to document the specific flap technique used, as generic closures or simple excisions do not qualify for this code.

Billing Tips

Ensure the average diameter of the defect is clearly documented in the operative report to justify the 2.1 to 5 cm range.
If a frozen section is performed in a hospital setting for a malignant lesion, remember to append the E540 premium to the R046 claim to increase the fee by 25%.

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Provider Fee$335.15

Surgical Assistant Fee$75.06

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

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