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R117
R117 – Skin sparing mastectomy performed with immediate breast reconstruction
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Skin sparing mastectomy performed with immediate breast reconstruction for malignancy or prophylaxis in high-risk female patients.
When to Use
- Use R117 for a skin-sparing mastectomy performed in conjunction with immediate breast reconstruction for a confirmed malignancy.
- Use R117 for prophylactic skin-sparing mastectomy in high-risk female patients when immediate reconstruction is performed.
Common Pitfalls
- Do not bill R117 concurrently with Z427, as the latter is explicitly excluded from the E505 add-on eligibility.
- Avoid billing R117 for simple mastectomies without immediate reconstruction, as this code is specifically defined by the inclusion of the reconstruction component.
- Failure to apply the E486 add-on when performing a nipple-sparing technique results in a 30% under-billing of the procedural fee.
Billing Tips
- Always append E486 to R117 if the nipple-areola complex is preserved, as this increases the base fee by 30%.
- If performing limited axillary node sampling concurrently, ensure E505 is claimed on the same day to capture the additional $178.05 fee.
Provider Fee$495.00
Surgical Assistant Fee$77.46
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72
Effective: April 1, 2026
Category
M. Integumentary System Surgical Procedures
Subcategory
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Integumentary System Surgical Procedures
Sex Restriction
Female
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