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Billing code

R111A — Partial Mastectomy Or Wedge Resection For Treatment Of Breast Disease, With Or Without Biopsy, E.g. Carcinoma Or Extensive Fibrocystic Disease

Partial mastectomy

Bill R111 for a partial mastectomy or wedge resection to treat breast disease such as carcinoma, with or without biopsy.

Watch for: E505 node sampling isn't payable with Z427 sentinel node biopsy; Z427 with E546 needs a frozen section showing micrometastases.

Code

R111A

Description

Partial Mastectomy Or Wedge Resection For Treatment Of Breast Disease, With Or Without Biopsy, E.g. Carcinoma Or Extensive Fibrocystic Disease

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

Partial mastectomy or wedge resection to treat breast disease such as carcinoma, with or without biopsy. Axillary node add-ons E505 and E546 apply.

What it covers

R111 is partial mastectomy or wedge resection for treatment of breast disease, with or without biopsy, for example carcinoma or extensive fibrocystic disease (M25).

Excision of breast tumour or tissue for diagnosis or treatment is the smaller R107; an oncoplastic breast conserving lumpectomy that meets its volume and operative report criteria is R102, R158 or R159 (M25, M26, M27).

Billing rules

• Add-ons to R111: E525 after mammographic wire or radioactive seed localization, E546 axillary node dissection up to the level of the axillary vein, and E505 limited axillary node sampling (M25).
• E505 isn't payable in addition to Z427 sentinel node biopsy (M25).
• Z427 is payable in addition to E546 only when a frozen section report shows micrometastases (M25).
• Other procedures under the same anaesthetic: the major procedure is paid in full and the others at 85% (SP2).
• 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

• E525 when the lesion was localized with a mammographic wire or radioactive seeds (M25).
• Z427 sentinel node biopsy per draining basin, without E505 (R2, M25).
• A034 General Surgery partial assessment, billable on the surgery day only if it is the major pre-operative visit (GP4, SP2).

Related codes: R107, R102, R158, E525, E505, E546, Z427, R108

Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Operations of the Breast, page M25; Surgical Preamble SP1 and SP2

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