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Billing code 48120: Pancreatic lesion excisionMedicare rate & RVUs

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 RVU26DEffective Oct 1, 2026109 payment localities81 Medicare services in 2024

Medicare pays $1,047.12 for 48120 nationally in a facility.

Medicare rate · 48120

Pancreatic lesion excision

Swap in your local Medicare rate.

Work RVUs
17.95
Total RVUs
31.35
Global days
090

National rate · 2026

$1,047.12

Facility setting, before claim adjustments.

See every locality for 48120 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 48120 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

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

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

109 of 109 payment localities

48120 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$941.63
Alaska*Unavailable$1,293.58
ArizonaUnavailable$1,015.13
ArkansasUnavailable$928.86
AtlantaUnavailable$1,085.74
AustinUnavailable$1,046.70
BakersfieldUnavailable$1,023.40
Baltimore/Surr. CntysUnavailable$1,115.68
BeaumontUnavailable$1,009.88
BrazoriaUnavailable$1,014.06

48120 rates by state

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

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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
48120 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

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

Swap in your local Medicare rate.

Work 17.95Practice expense 8.60Malpractice 4.80

31.3500 adjusted RVUs×$33.4009 conversion factor=$1,047.12

All indexes start 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

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 · 48120

Pancreatic lesion excision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

48120 without 51 · national facility

$1,047.12

Pancreatic lesion excision

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%).

When to use modifier 51

48120 compared with similar codes

Compare codes

48120 vs 48100 vs 48102 vs 48140: national Medicare rates

Swap in your local Medicare rate.

  • 48120
    Pancreatic lesion excision · 17.95 wRVU
    —
  • 48100
    Pancreatic biopsy · 14.1 wRVU
    —
  • 48102
    Pancreatic biopsy · 4.58 wRVU
    $492.66
  • 48140
    Pancreas resection · 25.66 wRVU
    —

How to choose

48100Pancreatic biopsy
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 biopsy
48102 describes needle sampling of the pancreas. 48120 describes open surgical removal of a localized lesion.
48140Pancreas resection
48140 is for distal subtotal pancreatectomy. Choose 48120 when the documented work is local lesion excision rather than removal of a pancreatic segment.

Codes related to 48120

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

Codes related to 48120
CodeHow it relatesNational office range
Used instead
48100Pancreatic biopsyOpen pancreatic biopsy is for tissue sampling when the lesion itself is not excised.No office rate
48102Pancreatic biopsyNeedle biopsy samples pancreatic tissue rather than removing a localized lesion.$439.14–$644.80
48140Pancreas resectionFor distal subtotal pancreatic removal rather than local excision of a lesion.No office rate

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
RVUs for 48120PPRRVU2026_Oct_nonQPP.csv, line 5,736 (RVU26D)

Open CMS sourceHow we calculate rates

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