CPT code 48153: Pancreaticoduodenectomy, proximal subtotal resection2026 Medicare rate & RVUs

Medicare pays $2,862.79 for 48153 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 48153 covers

This code represents a Whipple-type operation: the surgeon removes the proximal pancreas along with the duodenum and part of the stomach, creates a connection between the bile duct and intestine, and performs the pancreatic and gastrointestinal reconstruction specified by the code. It is generally performed by a pancreatic or hepatopancreatobiliary surgeon in a hospital operating room for conditions such as a resectable pancreatic-head or periampullary tumor. The operative report should establish the structures removed and the reconstruction performed.

Select this code by matching the documented procedure and reconstruction to the applicable pancreaticoduodenectomy code, rather than relying on the diagnosis alone. Report the completed operation once; do not separately report a component already included in the coded procedure. Medicare assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; 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 48153 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

48153 rates by state

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

How the 48153 rate is calculated

Each of 48153’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 48153

48153 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

48153 compared with similar codes

How to choose

48150Whipple procedureProximal resection with duodenectomy

Both are in the pancreaticoduodenectomy family. Choose by matching the operative report’s resection and reconstruction details to the code-specific requirements.

48152PancreatectomyProximal subtotal resection

This is a neighboring pancreaticoduodenectomy option. The documented operative configuration, not the tumor site alone, distinguishes the codes.

48155PancreatectomyTotal gland removal

48155 represents total pancreatectomy. This code is for the specified proximal pancreaticoduodenectomy rather than removal of the entire pancreas.

Codes related to 48153

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