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Billing code

Z125A — Group 3 - Cyst, Haemangioma, Lipoma - Other Areas - Local Anaesthetic - Single Lesion

Body cyst or lipoma removal

Bill for excising one cyst, haemangioma or lipoma outside the face and neck under local anaesthetic.

Watch for: One lesion only: two are Z126 and three or more Z127; cosmetic removal isn't insured.

Code

Z125A

Description

Group 3 - Cyst, Haemangioma, Lipoma - Other Areas - Local Anaesthetic - Single Lesion

FHO+ basket

Covered by the FHO+ base rate payment for enrolled patients, and shadow billed at 30% (50% for Schedule 2B procedures).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Excision of one cyst, haemangioma or lipoma outside the face and neck under local anaesthetic. Two lesions are Z126, three or more Z127.

What it covers

Z125 is excision, with or without biopsy, of a single Group 3 lesion (cyst, haemangioma or lipoma) outside the face and neck, under local anaesthetic (M3, M4).

As a Z code it is an independent operative procedure (IOP), payable in addition to an assessment (GP4).

Billing rules

• One lesion only: two lesions are Z126 and three or more Z127. Under general anaesthetic the same excisions are Z149 to Z151, and extensive or massive lesions are Z152 (IC) (M4).
• When no anaesthetic is required, the excision is still claimed under this local anaesthetic listing (SP5). No surgical assistant fee is payable (M4).
• E542 is added when the excision is done outside hospital (M4).
• Removal of lesions for cosmetic purposes, without clinical suspicion of disease or malignancy, is not an insured service (M3); such removals are billed to the patient (AD3).
• For benign lesions such as haemangiomas in areas other than the face or neck, removal is normally not insured when it is only to alter appearance rather than for medical necessity or clinical suspicion of malignancy (AD3). A lipoma of 5 to 10 cm is Z096, over 10 cm Z097 (M4).
• If you did the major pre-operative visit in the previous 12 months, only a minor assessment (GP/FP) or a partial assessment (specialist) is payable before the excision that day; if the decision is made at that day's visit, that visit is the major pre-operative visit and no other assessment before the excision is payable (GP4, SP4).
• FHO: a Schedule 2 core service and one of the Schedule 2B codes with 50% total shadow billing for enrolled patients; it also counts toward the Schedule 4 office procedures payment when done in the office (Agreement p.59 §4.4, p.80, p.87, p.67 §8.7, p.94).

Often billed with

• E542 when the excision is done in the office or elsewhere outside hospital (M4).
• A partial assessment, such as A034 (General Surgery), before the excision when you did the major pre-operative visit in the previous 12 months (SP4).
• On a non-elective special visit, the assessment, the special visit premium (for example U990 or U991 in a hospital out-patient department, weekday daytime) and the procedure are all billable (SP2, GP71).

Related codes: Z126, Z127, Z149, Z122, Z096, E542

Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, Excision (with or without biopsy), Group 3, pages M3 and M4; Appendix D AD3; Surgical Preamble SP4 and SP5

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