What is OHIP billing code R118?

R118 is "Breast skin reconstruction by local flaps or grafts", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R118 pay?

The current OHIP fee for R118 is $405.60, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R118 to OHIP?

R118 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R118 claims against the Schedule of Benefits rules before submission.

What codes are related to R118?

Codes related to R118 in the Schedule of Benefits include R119, R156, R125, R064, R008, R155, E529, E513.

All codes

R118

R118 – Breast skin reconstruction by local flaps or grafts

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

Ask AI Bill This Code — Sign Up Free

Breast skin reconstruction by local flaps or grafts is a surgical procedure performed for post-mastectomy breast reconstruction. The service involves creating skin coverage for the breast area using local tissue flaps, which may specifically involve Wise pattern skin flaps and de-epithelialized skin flaps. This procedure is a component of breast mound reconstruction and may be combined with other techniques for a complete restoration. The service is eligible for assistant and anaesthesia services, which are calculated based on basic units plus time units as described in the General Preamble (, ).

When to Use

Use R118 when performing breast skin reconstruction using local tissue flaps or grafts specifically for post-mastectomy breast reconstruction.
Use R118 as the base code when performing breast mound creation via autogenous tissue (E513) or prosthesis (E529) to provide the necessary skin coverage.

Common Pitfalls

Attempting to bill E513 and E529 together; these add-on codes are mutually exclusive and will trigger a rejection.
Billing R118 for non-mastectomy related breast procedures; the code is strictly restricted to post-mastectomy reconstruction as per M28.
Failing to include the required documentation for E514 when billing for immediate reconstruction, which must occur during the same anaesthesia as the mastectomy.

Billing Tips

Always pair R118 with the appropriate add-on (E513 for autogenous or E529 for prosthesis) to ensure the full scope of the reconstruction is captured.
If performing immediate reconstruction, ensure E514 is included on the claim to capture the additional flat fee for the same-day procedure.

Have a specific question? Ask our billing assistant

Provider Fee$405.60

Surgical Assistant Fee$75.06

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in