What is OHIP billing code Z728?

Z728 is "Incision and drainage of cyst, abscess or haematoma", an OHIP Psychiatric code from the Ontario Schedule of Benefits (Physician Services).

How much does Z728 pay?

The current OHIP fee for Z728 is $97.20, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill Z728 to OHIP?

Z728 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates Z728 claims against the Schedule of Benefits rules before submission.

All codes

Z728

Z728 – Incision and drainage of cyst, abscess or haematoma

OHIP Psychiatric Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits

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Incision and drainage of a cyst, abscess, or haematoma of the vagina. This is a surgical procedure found in the Female Genital Surgical Procedures section of the Schedule of Benefits. Anaesthesia services (using suffix C) are payable with 6 base units, plus time units as described in the General Preamble on page . This surgical procedure is eligible for age-based fee premiums as outlined on page .

When to Use

Use Z728 for the formal incision and drainage of a Bartholin's gland abscess or a vaginal wall hematoma.
Use this code when the procedure involves a surgical incision and evacuation of contents, distinguishing it from simple aspiration which may not meet the criteria for a formal I&D.

Common Pitfalls

Billing Z728 in addition to a consultation or assessment code on the same day is often rejected unless the assessment is for a separate, unrelated clinical issue.
Failure to append the appropriate age-based premium code when the patient is under 16 years old results in significant underpayment.
Attempting to bill Z728 alongside minor procedure codes like Z727 (biopsy) for the same lesion is considered unbundling and will lead to audit recovery.

Billing Tips

If the procedure is performed in an emergency department or hospital setting, ensure you check for eligibility for after-hours premiums (E409/E410) if the service meets the non-elective criteria.
Always document the specific location of the cyst or abscess (e.g., Bartholin's gland) in the operative note to support the use of the surgical code over a minor office procedure.

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Provider Fee$97.20

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

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