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Billing code

R108A — Mastectomy - Female (with Or Without Biopsy) - Simple

Simple mastectomy

Bill R108 for a simple mastectomy in a female patient, with or without biopsy.

Watch for: E517 (+30%) chest wall reconstruction is payable only when the extensive undermining or special closure is documented.

Code

R108A

Description

Mastectomy - Female (with Or Without Biopsy) - Simple

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Simple mastectomy in a female patient, with or without biopsy. E517 adds 30% for documented superficial chest wall reconstruction; E505 adds sampling.

What it covers

R108 is a simple mastectomy in a female patient, with or without biopsy (M25). Skin sparing mastectomy with immediate breast reconstruction is R117, and radical or modified radical mastectomy is R109 (M25, M26).

For patients approved by OHIP for mastectomy related to sex-reassignment surgery, the Schedule's commentary points to R108 plus R120 for nipple preservation and grafting (M26). That surgery is insured only with the Ministry's prior authorization (AD7, AD8).

Billing rules

• E517 (add 30%) for immediate post-mastectomy superficial chest wall reconstruction is payable only when the surgeon performed and documented extensive undermining for local advancement flaps over 10 cm to obliterate inferior or lateral excess flap deformities, or a modified M-plasty or fishtail closure (M25, M26).
• E505 limited axillary node sampling may be added to R108 (M25). E505 isn't payable in addition to Z427 sentinel node biopsy (M25).
• Listed fees are unilateral; for bilateral or other procedures under the same anaesthetic, the major procedure is paid in full and the others at 85% (SP4, SP2).
• R108 is on the list of procedures that take E676 for a morbidly obese patient, when BMI over 40 is recorded in the chart and the surgery is under general anaesthesia (SP6, SP7).
• The major pre-operative visit is billed separately; the surgeon can't bill a hospital or day care admission assessment unless it is that visit (GP4, SP2).
• Marked #: premises, equipment, supplies and personnel are not included in the fee (SP1, GP13).

Often billed with

• Z427 sentinel node biopsy per draining basin under the same anaesthetic, with the 85% rule for the second procedure (R2, SP2).
• E517 or E505 add-ons when their conditions are met (M25).
• A034 General Surgery partial assessment, billable on the surgery day only if it is the major pre-operative visit (GP4, SP2).

Related codes: R117, R109, E517, E505, Z427, R120, R111

Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Operations of the Breast, Mastectomy - female, pages M25 to M26; Surgical Preamble SP2, SP6; Appendix D AD7 to AD8

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