CPT code 48146: Pancreatectomy, distal subtotal with pancreaticojejunostomy2026 Medicare rate & RVUs

Medicare pays $1,767.91 for 48146 nationally in a facility.

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

What 48146 covers

The surgeon removes a substantial portion of the distal pancreas, generally the body and tail, and connects the remaining pancreatic tissue to the jejunum to drain pancreatic secretions. Splenectomy may be performed as part of the operation. This major abdominal procedure is typically performed by a surgeon in an operating room, often for pancreatic disease requiring more than a limited excision.

Select this code when the operative report supports a distal subtotal resection and pancreaticojejunostomy; the reconstruction is part of the coded service. Document the extent and location of the resection, the pancreatic remnant, and the anastomosis. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 48146 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

48146 rates by state

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

How the 48146 rate is calculated

Each of 48146’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 48146

48146 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

48146 compared with similar codes

How to choose

48145PancreatectomyDistal resection with jejunal anastomosis

Use 48146 when pancreaticojejunostomy is performed with the distal subtotal resection; 48145 describes the corresponding operation without it.

48140Pancreas resectionDistal, without pancreaticojejunostomy

48140 describes a different distal partial pancreatectomy service. Use 48146 when the documented operation is distal subtotal resection with pancreaticojejunostomy.

48150Whipple procedureProximal resection with duodenectomy

48150 is for a proximal subtotal pancreatic resection, while 48146 is for distal subtotal resection with pancreaticojejunostomy.

Codes related to 48146

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

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