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Billing code

Z156A — Group 1 - E.g. Keratosis, Pyogenic Granuloma - Removal By Excision And Suture - Single Lesion

Benign skin lesion excision

Bill for excising and suturing one Group 1 benign skin lesion, such as a keratosis or pyogenic granuloma.

Watch for: Cosmetic removal without suspicion of disease isn't insured and is billed to the patient.

Code

Z156A

Description

Group 1 - E.g. Keratosis, Pyogenic Granuloma - Removal By Excision And Suture - 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 and suture of one Group 1 benign skin lesion, such as a keratosis or pyogenic granuloma. Cosmetic removal isn't insured.

What it covers

Z156 is removal of a single Group 1 lesion (for example a keratosis or pyogenic granuloma) by excision and suture, with or without biopsy (M3).

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 Z157 and three or more Z158 (M3).
• E542 is added when the excision is done outside hospital (M3).
• 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).
• On the face or neck, excision of benign lesions such as keratoses is insured where there is any suspicion of disease or malignancy; in other areas it is normally not insured when it is only to alter appearance (AD3).
• Excision of plantar warts is not an insured service (M3, AD4).
• Excision of a pre-malignant lesion, such as an actinic keratosis or a dysplastic nevus, has its own codes, R160 to R165, paid at a lesser fee if the pathologist's report isn't kept in the record (M5).
• 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.81, p.88, p.67 §8.7, p.95).

Often billed with

• A007 intermediate assessment at the visit where the decision to excise is made (GP4, SP4).
• E542 when the excision is done in the office or elsewhere outside hospital (M3).

Related codes: Z157, Z158, Z159, Z162, R163, Z117, E542

Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, Excision (with or without biopsy), Group 1, page M3; pre-malignant lesions M5; Appendix D AD3–AD4; Surgical Preamble SP4

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