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R148

R148Mastectomy - male - simple

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

A unilateral simple mastectomy performed on a male patient for the treatment of pathological breast disease, for example, carcinoma. This procedure may be performed with or without a biopsy. As a surgical procedure, this service includes the specific elements of surgery as outlined in the Schedule's General Preamble, which encompasses pre-operative and post-operative care, unless specified otherwise. This service is for male patients only.

When to Use

  • Use R148 for a unilateral simple mastectomy in a male patient specifically for the treatment of pathological breast disease such as carcinoma.
  • Use R148 when performing a simple mastectomy without axillary node dissection, as this code covers the primary surgical procedure.

Common Pitfalls

  • Do not bill E505 in conjunction with Z427, as the Schedule explicitly prohibits payment for limited axillary node sampling when a sentinel node biopsy is performed.
  • Avoid billing R148 for cosmetic procedures like gynecomastia correction, as this code is strictly restricted to pathological breast disease.

Billing Tips

  • Ensure you append E505 to your R148 claim if you perform limited axillary node sampling concurrently to receive the additional flat fee of $178.05.
  • If an assistant or anaesthesiologist is present, remember to submit separate claims using the B or C suffix respectively to ensure appropriate unit-based compensation.
Provider Fee$311.95
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

Male

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