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

Report this code for distal subtotal removal of the pancreas when the surgeon reconnects the remaining pancreatic tissue to the jejunum.

CMS RVU26DEffective Oct 1, 2026One payment locality75 Medicare services in 2024

In Rhode Island, Medicare pays $1,774.72 for 48146 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,774.72Hospital or facility

Check a contract rate as a % of Medicare · 48146 nationwide

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

We’ll open 48146 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Rhode Island
  2. What 48146 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Rhode Island compares for 48146

Across 109 of 109 payment localities, the facility rate for 48146 runs from $1,562.27 in Wisconsin to $2,196.14 in Miami, FL. Rhode Island pays $1,774.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

48146 in Rhode Island vs other payment areas
  1. Rhode Island · this page$1,774.72
  2. Los Angeles, CA · California$1,811.57+$36.85
  3. Washington, DC area · District of Columbia$1,941.68+$166.96
  4. Miami, FL · Florida$2,196.14+$421.42
  5. Chicago, IL · Illinois$2,122.58+$347.86
  6. Manhattan, NY · New York$2,069.65+$294.93
  7. Alaska · Alaska$2,179.38+$404.66

Other areas in Rhode Island first, then benchmark localities. Bars start at $0.

Every other payment area

48146 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,589.15
ArkansasArkansas—$1,567.48
ArizonaArizona—$1,713.88
Bakersfield, CACalifornia—$1,731.08
Chico, CACalifornia—$1,709.63
El Centro, CACalifornia—$1,710.96
Fresno, CACalifornia—$1,709.63
Hanford, CACalifornia—$1,709.63

48146 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
48146 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 48146 in every payment locality

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.

How the rate is built · 48146

RVUs × geographic indexes × conversion factor

Office or facility?

Work29.84

29.84 RVUs× 1.000 GPCI

Practice expense15.11

15.11 RVUs× 1.000 GPCI

Malpractice7.98

7.98 RVUs× 1.000 GPCI

Adjusted RVUs

52.9300

Conversion factor

$33.4009

Medicare rate

$1,767.91

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Rhode Island inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,739

Code
48146
Physician work
29.84
Practice expense
15.11
Malpractice
7.98

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Facility calculation for 48146 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work29.84× 1.01930.4070
Practice expense15.11× 1.03315.6086
Malpractice7.98× 0.8927.1182
Total RVUs53.1337
Conversion factor× 33.4009

Facility rate, Rhode Island$1774.72

Facility: (29.84 × 1.019 + 15.11 × 1.033 + 7.98 × 0.892) × $33.4009 = $1774.72

Open 48146 in the RVU calculator

Payment rules and modifiers for 48146

48146 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 48146

Pancreatectomy, distal subtotal with pancreaticojejunostomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 48146

Pancreatectomy, distal subtotal with pancreaticojejunostomy

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

48146 without 51 · national facility

$1,767.91

Pancreatectomy, distal subtotal with pancreaticojejunostomy

48146-51 · Second procedure: 50%

$883.96

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%).

When to use modifier 51

How 48146 has changed in Rhode Island

48146 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,774.72RVU26D
2026-07-01Not available in this setting$1,774.72RVU26C
2026-04-01Not available in this setting$1,774.72RVU26B
2026-01-01Not available in this setting$1,774.72RVU26A
2025-10-01Not available in this setting$1,843.44RVU25D
2025-07-01Not available in this setting$1,843.44RVU25C
2025-04-01Not available in this setting$1,843.44RVU25B
2025-01-01Not available in this setting$1,843.44RVU25A
2024-10-01Not available in this setting$1,888.96RVU24D
2024-07-01Not available in this setting$1,888.96RVU24C
2024-04-01Not available in this setting$1,888.96RVU24B
2024-03-09Not available in this setting$1,888.96RVU24AR
2024-01-01Not available in this setting$1,858.13RVU24A
2023-10-01Not available in this setting$1,935.47RVU23D
2023-07-01Not available in this setting$1,935.47RVU23C
2023-04-01Not available in this setting$1,935.47RVU23B
2023-01-01Not available in this setting$1,935.47RVU23A
2022-10-01Not available in this setting$1,999.32RVU22D
2022-07-01Not available in this setting$1,999.32RVU22C
2022-04-01Not available in this setting$1,999.32RVU22B
2022-01-01Not available in this setting$1,999.32RVU22A
2021-10-01Not available in this setting$2,000.39RVU21D
2021-07-01Not available in this setting$2,000.39RVU21C
2021-04-01Not available in this setting$2,000.39RVU21B
2021-01-01Not available in this setting$2,000.39RVU21A
2020-10-01Not available in this setting$2,037.65RVU20D
2020-07-01Not available in this setting$2,037.65RVU20C
2020-04-01Not available in this setting$2,037.65RVU20B
2020-01-01Not available in this setting$2,037.65RVU20A
2019-10-01Not available in this setting$2,029.75RVU19D
2019-07-01Not available in this setting$2,029.75RVU19C
2019-04-01Not available in this setting$2,023.99RVU19B
2019-01-01Not available in this setting$2,023.99RVU19A
2018-10-01Not available in this setting$2,020.11RVU18D
2018-07-01Not available in this setting$2,020.11RVU18C
2018-04-01Not available in this setting$2,020.11RVU18B
2018-01-01Not available in this setting$2,020.11RVU18AR1
2017-10-01Not available in this setting$1,974.23RVU17D
2017-07-01Not available in this setting$1,974.23RVU17C
2017-04-01Not available in this setting$1,974.23RVU17B
2017-01-01Not available in this setting$1,974.23RVU17A
2016-10-01Not available in this setting$1,941.85RVU16D
2016-07-01Not available in this setting$1,941.85RVU16C
2016-04-01Not available in this setting$1,941.85RVU16B
2016-01-01Not available in this setting$1,941.85RVU16A
2015-10-01Not available in this setting$1,947.62RVU15D
2015-07-01Not available in this setting$1,947.62RVU15C
2015-04-01Not available in this setting$1,937.93RVU15B
2015-01-01Not available in this setting$1,937.93RVU15A
2014-10-01Not available in this setting$1,961.40RVU14D
2014-07-01Not available in this setting$1,961.40RVU14C
2014-04-01Not available in this setting$1,961.40RVU14B
2014-01-01Not available in this setting$1,961.40RVU14A
2013-10-01Not available in this settingRate data unavailableRVU13D
2013-07-01Not available in this settingRate data unavailableRVU13C
2013-04-01Not available in this settingRate data unavailableRVU13B
2013-01-01Not available in this settingRate data unavailableRVU13AR

Price 48146 for an earlier date of service

Where the Rhode Island rate applies

Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.

  • Ashaway
  • Bradford
  • Carolina
  • Central Falls
  • Charlestown
  • Chepachet
  • Clayville
  • Cranston

Browse all communities in Rhode Island

48146 billing questions

How does this differ from 48145?

Both describe distal subtotal pancreatectomy. Choose 48146 when the operation includes pancreaticojejunostomy; 48145 is the corresponding option without that reconstruction.

Is the pancreaticojejunostomy separately reported?

It is included in this service. The operative documentation should establish that the surgeon connected the pancreatic remnant to the jejunum.

Should modifier 50 be appended?

No. Modifier 50 is inappropriate for this pancreatic operation.

What documentation supports this code?

The operative report should identify the distal subtotal extent of resection and describe the pancreaticojejunostomy. It should also clarify whether splenectomy was performed.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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
RVUs for 48146PPRRVU2026_Oct_nonQPP.csv, line 5,739 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)

Open CMS sourceHow we calculate rates

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