All codes
R120
R120 – Nipple-areola reconstruction by grafts and/or flaps
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the repair of the breast, specifically the reconstruction of the nipple-areola complex using grafts and/or flaps, as listed on page . This procedure is typically performed as part of a post-mastectomy breast reconstruction, and is listed with related codes such as R118 (Breast skin reconstruction) and R142 (Nipple-areola tattooing).
When to Use
- Use R120 specifically for the surgical creation of a nipple-areola complex using local tissue flaps or skin grafts following a prior mastectomy.
- Use this code when performing a secondary procedure to reconstruct the nipple-areola complex after the initial breast mound reconstruction is complete.
Common Pitfalls
- Do not bill R120 in conjunction with R142 (Nipple-areola tattooing) if the tattooing is performed during the same operative session, as R120 is intended for the structural reconstruction itself.
- Avoid billing R120 for simple nipple revision or scar revision; it is strictly for the reconstruction of the complex, and using it for minor revisions may trigger audit flags.
Billing Tips
- Ensure that the surgical report clearly documents the use of flaps or grafts, as the Ministry may request operative notes to verify the procedure meets the definition of R120 versus simpler cosmetic enhancements.
Provider Fee$300.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Category
M. Integumentary System Surgical Procedures
Subcategory
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Integumentary System Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.