Billing code
Z096A — Group 4 - Other Lesions - Lipoma 5 To 10 Cm
Lipoma removal, 5–10 cm
Bill for excising a lipoma 5 to 10 cm; over 10 cm is Z097, and smaller ones use the cyst and lipoma codes.
Watch for: Removal for cosmetic reasons, without suspicion of disease, isn't insured; add E542 outside hospital.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $87.65 | $0.00 | $77.46 | $95.76 | $95.76 |
- Code
- Z096A
- Description
- Group 4 - Other Lesions - Lipoma 5 To 10 Cm
- 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
Excision of a lipoma 5 to 10 cm. Larger lipomas (over 10 cm) are Z097; smaller ones use the cyst, haemangioma and lipoma codes.
What it covers
Z096 is excision of a lipoma 5 to 10 cm, listed under Group 4 – other lesions in Skin and Subcutaneous Tissue (M4). A lipoma over 10 cm is Z097; smaller lipomas fall under the Group 3 cyst, haemangioma, lipoma codes (Z122–Z127 under local, Z145–Z152 under general anaesthetic) (M4).
Removing a lesion for cosmetic reasons, without clinical suspicion of disease or malignancy, is not insured (M3).
Billing rules
- Add E542 when done outside a hospital (M4).
- As a Z-code (independent operative procedure), if the major pre-operative visit was in the previous 12 months, only a minor assessment (GP) or partial assessment (specialist) is payable before the procedure that day (SP4).
- For several independent operative procedures at the same time, claim each procedural fee in full, but pre- and post-operative care as if one procedure was done (SP4).
- A minor procedure plus assessment and treatment of an unrelated, significant problem in another body system at the same visit: bill both (SP4).
- Age premium applies to surgical procedures for patients under 16 (GP64).
- FHO: Z096A is a Schedule 4 office procedure code for the office procedures special payment (Agreement Schedule 4, p.92–97; §8.7).
Often billed with
- E542 when performed outside hospital (M4).
Related codes: Z097, Z125, Z149, Z122, Z145, E542
Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, page M4.
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