What are the billing rules for Z401A?

R707 (surgical pericardial drainage for tamponade) can't be billed in addition to pericardiocentesis (Q5). Z codes are Independent Operative Procedures: if you did the major pre-operative visit in the past 12 months, only a minor assessment (family physician) or partial assessment (specialist) is payable before the procedure that day; if the major pre-operative visit is the same day, no other assessment before it is payable (SP4). Non-elective surgical procedures started in the evening, on a weekend or holiday, or at night take an after-hours premium: E412 (+20%) or E413 (+40%) for an Emergency Department Physician billing H codes, or E409 (+50%) or E410 (+75%) for other physicians (GP103, GP104).

What is Z401A often billed with?

E412/E413 or E409/E410 when non-elective and done after hours (GP104).

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Billing code

Z401A — Thoracotomy - Aspiration Of Pericardium

Q: What is OHIP billing code Z401A?

Aspiration of fluid from the pericardium (pericardiocentesis).

Pericardial fluid aspiration

Bill for aspirating fluid from the pericardium.

Watch for: Surgical pericardial drainage for tamponade (R707) can't be billed in addition to pericardiocentesis.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$131.70	$0.00	$0.00	$0.00	$0.00

Code: Z401A
Description: Thoracotomy - Aspiration Of Pericardium
FHO+ basket: Not in the FHO+ base rate basket (Schedule 2 or 2B).
Effective date: Apr 1, 2025
Termination date: No end date

Explanation

Updated October 26, 2026

Aspiration of fluid from the pericardium (pericardiocentesis).

What it covers

Z401 is aspiration of the pericardium, listed with heart and pericardium procedures (Q5).

Related listings on the same page: injection of pericardial sclerosing agents (Z414), open biopsy and drainage of the pericardium (R750), and surgical drainage of a pericardial effusion for tamponade (R707) (Q5).

Billing rules

R707 (surgical pericardial drainage for tamponade) can't be billed in addition to pericardiocentesis (Q5).
Z codes are Independent Operative Procedures: if you did the major pre-operative visit in the past 12 months, only a minor assessment (family physician) or partial assessment (specialist) is payable before the procedure that day; if the major pre-operative visit is the same day, no other assessment before it is payable (SP4).
Non-elective surgical procedures started in the evening, on a weekend or holiday, or at night take an after-hours premium: E412 (+20%) or E413 (+40%) for an Emergency Department Physician billing H codes, or E409 (+50%) or E410 (+75%) for other physicians (GP103, GP104).
Patients under 16: payment is increased by 10% to 30% depending on age (GP64).

Often billed with

E412/E413 or E409/E410 when non-elective and done after hours (GP104).

Related codes: Z414, R750, R707, R748, R749

Source: Schedule of Benefits (July 1, 2026), Cardiovascular Surgical Procedures, Heart and Pericardium, page Q5.

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