OHIP billing code for skin biopsy
Updated October 26, 2026
Bill Z113A ($32.45) for a skin biopsy, by any method, when no sutures are used, and Z116A ($32.45) when the site is closed with sutures. Add E542A ($12.65) to Z116A when it's done in the office or anywhere outside a hospital.
| Code | What it is | Fee | When to bill it |
|---|---|---|---|
| Z113A | Biopsy(ies), any method, without sutures | $32.45 | Punch or shave biopsy left to heal without sutures. |
| Z116A | Biopsy(ies), any method, with sutures | $32.45 | Biopsy closed with sutures. |
| E542A | Procedure performed outside hospital (add-on) | $12.65 | Add to Z116A when done in the office. |
How to bill it
Pick the code by closure: no sutures, Z113A; sutures, Z116A (M1).
In the office, add E542A to Z116A. In the Schedule, E542 is printed under Z116, not Z113 (M1).
If you decide to biopsy at today's visit, bill the assessment and the biopsy. If you did the major pre-operative visit in the previous 12 months, only a minor assessment is payable before the biopsy that day (SP4).
Billing rules
- Z116 may be allowed more than once only on an independent consideration basis, when needed to biopsy more than one lesion or take a second biopsy from an extensive lesion (M1).
- An extensive or complicated biopsy, or one needing general anaesthetic as the sole procedure, is Z155 (independent consideration) (M2).
- An unrelated, significant problem in another body system assessed at the same visit can be billed as well (SP4).
- FHO: Z113 and Z116 are in basket and on the Schedule 2B list, so shadow billing for enrolled patients is 50% of the fee. Done in the office for enrolled patients, they count toward the office procedures payment ($2,000 once Schedule 4 codes reach $1,200 in the fiscal year) (Agreement p.59 §4.4, §8.7).
Questions
What is the OHIP billing code for skin biopsy?
Bill Z113A ($32.45) for a skin biopsy, by any method, when no sutures are used, and Z116A ($32.45) when the site is closed with sutures. Add E542A ($12.65) to Z116A when it's done in the office or anywhere outside a hospital.
Can I bill E542 with Z113?
No. In the Schedule, E542 is listed with Z116, the biopsy with sutures, not with Z113 (M1).
How do I bill several biopsies at one visit?
Z113 covers biopsy(ies) without sutures. A second Z116 is only allowed on an independent consideration basis when medically necessary (M1).
Related: OHIP billing code for laceration repair
Sources
- Schedule of Benefits: Physician Services (July 1, 2026)
- INFOBulletin 260308: 2024 PSA, FHO+ implementations for April 2026
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