Billing code
Z097A — Group 4 - Other Lesions - Lipoma Over 10 Cm
Lipoma removal, over 10 cm
Bill for surgically excising a lipoma larger than 10 cm.
Watch for: Bill by size: a 5 to 10 cm lipoma is Z096; cosmetic removal without suspicion of disease isn't insured.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $175.30 | $0.00 | $77.46 | $95.76 | $95.76 |
- Code
- Z097A
- Description
- Group 4 - Other Lesions - Lipoma Over 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
Surgical excision of a lipoma larger than 10 cm.
What it covers
Z097 is excision (with or without biopsy) of a lipoma over 10 cm, listed under Group 4 – other lesions (M4).
A lipoma of 5 to 10 cm is Z096; smaller lipomas are in Group 3 (cyst, haemangioma, lipoma) by site, number and anaesthetic (M4).
Billing rules
- Removing lesions purely for cosmetic reasons, without clinical suspicion of disease, is not insured (M3).
- As a Z-code procedure it is an Independent Operative Procedure (IOP): if your major pre-operative visit was in the prior 12 months, only a partial assessment is payable earlier that day (SP4 §13).
- Surgical assistant and anaesthesia basic units are listed; the assistant bills with suffix B and the anaesthetist with suffix C (M4, SP5 §21).
- 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).
Related codes: Z096, Z149, Z125, Z145
Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, page M4.
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