What are the billing rules for Z226A?

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 Z226 that day (SP4). If the decision to drain is made at that day's visit, that visit is the major pre-operative visit and no other consultation or assessment before the procedure is payable that day (GP4, SP4). Multiple or bilateral IOPs at the same time: claim each procedural fee in full, but the pre- and post-operative care as if only one procedure was done (SP4).

What is Z226A often billed with?

An assessment at the visit where the decision to drain is made, within the IOP limits above (GP4, SP4).

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Billing code

Z226A — Soft Tissue Or Bursa, Incision And Drainage

Q: What is OHIP billing code Z226A?

Incision and drainage of soft tissue or a bursa, in the musculoskeletal surgery listings. As a Z code, an assessment can be billed as well.

Soft tissue or bursa drainage

Bill for incision and drainage of soft tissue or a bursa; as an independent procedure, an assessment can be billed too.

Watch for: The fee doesn't include premises, equipment, supplies or staff for the procedure itself.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$97.35	$0.00	$0.00	$111.72	$111.72

Code: Z226A
Description: Soft Tissue Or Bursa, Incision And Drainage
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

Incision and drainage of soft tissue or a bursa, in the musculoskeletal surgery listings. As a Z code, an assessment can be billed as well.

What it covers

Z226 is incision and drainage of soft tissue or a bursa in the Musculoskeletal System Surgical Procedures section. The same code is listed under Incision and Drainage for the elbow and forearm (N17), shoulder, arm and chest (N24), pelvis and hip (N37), femur (N41), knee (N47), fibula and tibia (N50) and foot and ankle (N54).

As a Z-prefix code it is an independent operative procedure (IOP), payable in addition to an assessment (GP4). It is marked #, so the fee doesn't include the premises, equipment, supplies and staff for the procedure itself (SP1).

Billing rules

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 Z226 that day (SP4).
If the decision to drain is made at that day's visit, that visit is the major pre-operative visit and no other consultation or assessment before the procedure is payable that day (GP4, SP4).
Multiple or bilateral IOPs at the same time: claim each procedural fee in full, but the pre- and post-operative care as if only one procedure was done (SP4).
Anaesthesia: 7 basic units plus time units, billed as Z226C (N17, SP5).
No assistant units are listed. An assistant is paid only after a medical consultant authorizes it on a letter from the surgeon, billed as M400B using the anaesthesia basic units (GP85).
A non-elective drainage on a special visit: assessment plus special visit premium plus Z226; from 17:00 to 07:00 and on weekends and holidays add E409 or E410 (SP2, GP104).
Age premiums apply to patients under 16 (GP64).

Often billed with

An assessment at the visit where the decision to drain is made, within the IOP limits above (GP4, SP4).

Related codes: Z227, Z101, Z102, Z228, R228, R595

Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Incision and Drainage, first listed under Elbow and Forearm, page N17 (also N24, N37, N41, N47, N50, N54); Surgical Preamble SP1-SP5; General Preamble GP4, GP85, GP104

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