CPT code 48120: Pancreatic lesion excision, open local removal2026 Medicare rate & RVUs in Vermont

In Vermont, Medicare pays $965.05 for 48120 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 48120 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

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.

How Vermont compares for 48120

Across 109 of 109 payment localities, the facility rate for 48120 runs from $924.11 in Wisconsin to $1,304.03 in Miami, FL. Vermont pays $965.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

48120 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 48120 in every payment locality

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.

Payment rules and modifiers for 48120

48120 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 48120

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 48120 has changed in Vermont

Price 48120 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

• Albany
• Alburgh
• Algiers
• Arlington
• Ascutney
• Bakersfield
• Barnet
• Barre

Browse all communities in Vermont

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

Open CMS sourceHow we calculate rates