Table 4Cost Estimates Based on the Ontario Schedule of Benefits for Physician Services Under the Health Insurance Act (September 2011)51

Fee
Code
DescriptionTech. Fees
($)
Prof. Fees
($)
Total
Costs
($)
SLNB
J861Radionuclide lymphangiogram115.1062.20165.30
Z427Sentinel node biopsy, per draining basin330.45 (Surg)
72.24 (Asst)
120.08 (Anes)
522.77
L865Surgical pathology, level 5
Gross and microscopic examination of the
following specimens: lymph nodes
(regional resection; sentinel)
103.20103.20
TOTAL791.27791.27
SLNB (with blue dye alone)
Z427Sentinel node biopsy, per draining basin330.45 (Surg)
72.24 (Asst)
120.08 (Anes)
522.77
L865Surgical pathology, level 5
Gross and microscopic examination of the
following specimens: lymph nodes
(regional resection; sentinel)
103.20103.20
TOTAL625.97625.97
ALND
R111Partial mastectomy or wedge resection
for treatment of breast disease, with or
without biopsy; e.g., carcinoma or
extensive fibrocystic disease
269.40 (Surg)
72.24 (Asst)
105.07 (Anes)
446.71
E546With axillary node dissection up to the
level of the axillary vein
388.75388.75
L865Surgical pathology, level 5
Gross and microscopic examination of the
following specimens: lymph nodes
(regional resection; sentinel)
103.20103.20
TOTAL938.66938.66

ALND = axillary lymph node dissection; anes = anesthetic; asst. = assistant; prof. = professional; SLNB = sentinel lymph node biopsy; surg = surgical; tech. = technical.

From: APPENDIX 2.16, Identification of the Sentinel Lymph Node in Patients with Breast Cancer

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Optimizing Health System Use of Medical Isotopes and Other Imaging Modalities [Internet].
Mujoomdar M, Russell E, Dionne F, et al.
Copyright © 2012 CADTH.

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