What is OHIP billing code Z258?

Z258 is "Zygoma - bilateral", an OHIP Psychiatric code from the Ontario Schedule of Benefits (Physician Services).

How much does Z258 pay?

The current OHIP fee for Z258 is $450.50, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill Z258 to OHIP?

Z258 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates Z258 claims against the Schedule of Benefits rules before submission.

All codes

Z258

Z258 – Zygoma - bilateral

OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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Bilateral onlay bone grafts or alloplastic reconstruction to the zygoma, performed when not part of a standard osteotomy for reconstruction.

When to Use

Use Z258 when performing bilateral zygomatic augmentation using alloplastic implants or onlay bone grafts for aesthetic or reconstructive purposes independent of a formal orthognathic osteotomy.
Select Z258 for bilateral zygomatic contouring procedures where the primary intent is volume restoration or structural support using synthetic materials like titanium mesh or high-density polyethylene.

Common Pitfalls

Do not bill Z258 if the zygomatic reconstruction is already included as a component of a comprehensive osteotomy procedure, as this constitutes unbundling.
Avoid billing Z258 for unilateral procedures; ensure the documentation explicitly confirms bilateral placement to avoid rejection or audit recovery.

Billing Tips

Always append E553 when using banked bone or synthetic bone substitutes to capture the additional flat fee allowance for materials.

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Provider Fee$450.50

Effective: April 1, 2025

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