R050 – Malignant lesions - three or more lesions (face or neck)
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Service for the simple excision of three or more malignant lesions, including biopsy of each, from the face or neck. Payment Note: The amount payable for treatment of a malignant lesion will be adjusted to a lesser fee if the pathologist's report is not retained in the patient's record. A pre-malignant lesion is not a malignant lesion for the purposes of payment. Billing Interaction: When excision of benign, pre-malignant or malignant lesions are corrected by advancement, rotation, transposition, Z-plasty, flap or graft, claim appropriate benefit listed under the Repair Section instead of this excision benefit. Commentary: For sentinel node biopsy refer to Z427 on page .
When to Use
- Use R050 when performing a simple excision of three or more distinct malignant lesions located on the face or neck during the same operative session.
- Use this code when the procedure is limited to simple excision; if the defect requires reconstruction via flap or graft, you must bill the appropriate Repair section code instead.
Common Pitfalls
- Billing R050 for pre-malignant lesions (e.g., actinic keratosis) will result in a clawback upon audit, as the Schedule of Benefits explicitly restricts this code to malignant diagnoses.
- Failure to retain the formal pathology report in the patient's chart is a common trigger for payment adjustment to a lower fee, as the Ministry requires histological confirmation for malignant lesion claims.
- Attempting to bill R050 alongside individual excision codes for the same site is redundant and will lead to rejection; R050 is a bundled fee for the group of three or more.
Billing Tips
- If the excision is performed in a non-hospital setting, ensure you append the E542 add-on code to capture the additional fee for office-based surgery.
- Always verify that the pathology report confirms malignancy for each of the three or more lesions, as the code requires biopsy confirmation for the entire set to justify the bundled fee.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
The pathologist's report must be retained in the patient's record.
Anaesthesia fee (<suffix>C</suffix>) is based on 7 basic units plus time units.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.