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R149
R149 – Mastectomy - male - subcutaneous with nipple preservation
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for a unilateral subcutaneous mastectomy with nipple preservation, for the treatment of pathological male breast disease (e.g., carcinoma), with or without a biopsy. The procedure is specifically for male patients.
When to Use
- Use R149 for a unilateral subcutaneous mastectomy with nipple preservation specifically for male patients diagnosed with carcinoma or other pathological breast disease.
- Use R149 when performing a mastectomy that preserves the nipple-areolar complex, distinguishing it from more radical mastectomy procedures.
Common Pitfalls
- Do not bill R149 in conjunction with Z427 (sentinel node biopsy), as the E505 add-on for limited axillary node sampling is the only permitted axillary procedure code for this service.
- Avoid billing R149 for cosmetic gynecomastia surgery, as the code is strictly restricted to pathological male breast disease.
Billing Tips
- If limited axillary node sampling is performed alongside the mastectomy, ensure you append E505 to your claim to receive the additional flat fee of $178.05.
Provider Fee$273.95
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
Sex Restriction
Male
Unilateral - for treatment of pathological male breast disease (with or without biopsy), e.g. carcinoma
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