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Background: It is well established that female physicians in Canada are reimbursed at lower rates than their male counterparts. To explore if a similar discrepancy exists in reimbursement for care provided to female and male patients, we addressed this question: Do Canadian provincial health insurers reimburse physicians at lower rates for surgical care provided to female patients than for similar care provided to male patients? Methods: Using a modified Delphi process, we generated a list of procedures performed on female patients, which we paired with equivalent procedures performed on male patients. We then collected data from provincial fee schedules for comparison. Results:In 8 out of 10 Canadian provinces and territories studied, we found that surgeons were reimbursed at significantly lower rates (26.7%) for procedures performed on female patients than for similar procedures performed on male patients.