CPT code 48120: Pancreatic lesion excision, open local removal2026 Medicare rate & RVUs in Massachusetts
Reports open local removal of a pancreatic lesion, such as a cyst or adenoma, when the surgeon excises the lesion rather than sampling it.
CMS doesn’t publish an office rate for 48120 in Massachusetts.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 48120 covers
This code describes open surgical removal of a localized pancreatic lesion, such as a cyst or adenoma, while preserving the distinction between local excision and removal of a larger portion of the gland. A general or hepatopancreatobiliary surgeon typically performs the operation in a hospital operating room. The excised tissue may be submitted for pathologic examination. Needle or open biopsy is a different service when the surgeon obtains tissue for diagnosis without removing the lesion.
Select the code from the operative report’s description of the lesion and the extent of pancreatic tissue removed. Documentation should establish that the surgeon excised a localized lesion through an open approach and clarify whether the work instead involved biopsy or partial pancreatectomy. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. CMS may pay for an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 48120 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | $1,109.79 |
| Rest of Massachusetts | Unavailable | $1,039.39 |
How the 48120 rate is calculated
Each of 48120’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 48120
RVUs × geographic indexes × conversion factor
Work17.95
17.95 RVUs× 1.000 GPCI
Practice expense8.60
8.60 RVUs× 1.000 GPCI
Malpractice4.80
4.80 RVUs× 1.000 GPCI
Adjusted RVUs
31.3500
Conversion factor
$33.4009
Medicare rate
$1,047.12
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 48120
48120 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 48120
Pancreatic lesion excision, open local removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 48120
Pancreatic lesion excision, open local removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
48120 without 51 · national facility
$1,047.12
Pancreatic lesion excision, open local removal
48120-51 · Second procedure: 50%
$523.56
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
48120 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 48100Pancreatic biopsyOpen approach
- Use 48100 when the surgeon obtains pancreatic tissue through an open biopsy without removing the lesion. Use 48120 for open excision of the localized lesion.
- 48102Pancreatic biopsyPercutaneous needle
- 48102 describes needle sampling of the pancreas. 48120 describes open surgical removal of a localized lesion.
- 48140Pancreas resectionDistal, without pancreaticojejunostomy
- 48140 is for distal subtotal pancreatectomy. Choose 48120 when the documented work is local lesion excision rather than removal of a pancreatic segment.
48120 billing questions
How does this differ from a pancreatic biopsy?
Report this code when the surgeon removes a localized lesion. Use a biopsy code when the surgeon samples pancreatic tissue without excising the lesion.
How does this differ from partial pancreatectomy?
This code represents local lesion excision. A partial pancreatectomy code is appropriate when the operative report documents removal of a pancreatic segment.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are paid at 50% under the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
CMS may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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