< Billing codes

Billing code

R153A — Plastic surgery procedure – major

Major plastic surgery

Bill R153 for a plastic surgery procedure without its own listing that the specialist classes as major.

Watch for: Send the operative report with the claim; not payable for laceration repair or to family practice or emergency medicine.

Code

R153A

Description

Plastic surgery procedure – major

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

Plastic surgery procedure classed by the specialist as major, for procedures without a specific listing. Send an operative report.

What it covers

R150 to R154 are general plastic surgery procedure categories. The responsible specialist classes the procedure as very minor, minor, intermediate, major or extensive major; the listed amount is the minimum benefit for each, and hard-to-define cases are claimed IC (M24).

R153 is the major category (M24).

Billing rules

• Submit descriptive details of the procedure (for example the operative report) with the claim for professional assessment (M24).
• Not payable for repair of any laceration; use the laceration repair codes (M24, M16).
• Not payable to General and Family Practice (00) or Emergency Medicine (12) (M24).
• When the procedure has its own specific listing, use that instead of these generic codes (SP4 §14).
• Marked #: the fee does not include premises, equipment, supplies or staff; in hospital these are funded by the hospital budget, and patients can't be charged for them (GP13).
• Age premiums apply for patients under 16, from 10% to 30% by age (GP64).

Common rejections

• A4D: OHIP describes this as 'Invalid specialty for this service code': R150–R154 are not payable to Family Practice (00) or Emergency Medicine (12) (M24).

Related codes: R150, R151, R152, R154, R990

Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, page M24.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing