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Billing code 48500: Pancreatic surgeryMedicare rate & RVUs

Reports surgical removal of a pancreatic cyst, rather than drainage or creation of an internal drainage connection, when excision is the operation performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,091.88 for 48500 nationally in a facility.

Medicare rate · 48500

Pancreatic surgery

Swap in your local Medicare rate.

Work RVUs
17.71
Total RVUs
32.69
Global days
090

National rate · 2026

$1,091.88

Facility setting, before claim adjustments.

See every locality for 48500 → · 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 48500 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 48500 covers

This service is the surgical excision of a cyst arising in the pancreas. A surgeon performs it in an operating room when the operative plan is to remove the cyst, rather than simply drain its contents or connect it to the stomach or intestine. The operative report should identify the cyst’s location and describe the tissue removed and the procedure performed.

Report 48500 when the operation is cyst excision; use a drainage or anastomosis code when that is the procedure performed. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate for this pancreatic procedure. Assistant-at-surgery payment may be allowed; 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 48500 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

48500 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$980.41
Alaska*Unavailable$1,338.79
ArizonaUnavailable$1,058.47
ArkansasUnavailable$966.86
AtlantaUnavailable$1,130.94
AustinUnavailable$1,094.85
BakersfieldUnavailable$1,074.05
Baltimore/Surr. CntysUnavailable$1,163.83
BeaumontUnavailable$1,049.85
BrazoriaUnavailable$1,058.70

48500 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
48500 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 48500 rate is calculated

Each of 48500’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 · 48500

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.71Practice expense 10.24Malpractice 4.74

32.6900 adjusted RVUs×$33.4009 conversion factor=$1,091.88

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 48500

48500 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 48500

Pancreatic surgery

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 · 48500

Pancreatic surgery

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

48500 without 51 · national facility

$1,091.88

Pancreatic surgery

48500-51 · Second procedure: 50%

$545.94

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

48500 compared with similar codes

Compare codes

48500 vs 48510 vs 48520 vs 48540 vs 48120: national Medicare rates

Swap in your local Medicare rate.

  • 48500
    Pancreatic surgery · 17.71 wRVU
    —
  • 48510
    Pseudocyst drainage · 16.76 wRVU
    —
  • 48520
    Cystogastrostomy · 17.7 wRVU
    —
  • 48540
    Pancreatic cyst drainage · 21.39 wRVU
    —
  • 48120
    Pancreatic lesion excision · 17.95 wRVU
    —

How to choose

48510Pseudocyst drainage
Use 48500 for excision of the cyst; 48510 describes drainage of a pancreatic pseudocyst.
48520Cystogastrostomy
Use 48520 when the procedure connects a pancreatic cyst to the stomach for internal drainage, rather than excising the cyst.
48540Pancreatic cyst drainage
Use 48540 for internal drainage by connecting the pancreatic cyst to intestine; 48500 is for excision.
48120Pancreatic lesion excision
48120 describes open excision of a pancreatic lesion, which may include a cyst. Select the code that matches the documented operation and applicable procedure description.

Codes related to 48500

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

Codes related to 48500
CodeHow it relatesNational office range
Used instead
48510Pseudocyst drainageReports drainage of a pancreatic pseudocyst rather than cyst excision.No office rate
48520CystogastrostomyCreates an internal drainage connection between a pancreatic cyst and the stomach.No office rate
48540Pancreatic cyst drainageCreates an internal drainage connection between a pancreatic cyst and intestine.No office rate
48120Pancreatic lesion excisionCovers open excision of a pancreatic lesion, including a cyst, when that lesion-excision service is performed.No office rate
48140Pancreas resectionDescribes distal subtotal pancreatectomy rather than excision of a pancreatic cyst.No office rate

48500 billing questions

How is cyst excision different from pancreatic cyst drainage?

Use 48500 when the surgeon removes the cyst. For drainage without excision, consider 48510; for internal drainage through an anastomosis, consider 48520 or 48540, as applicable.

What documentation supports reporting 48500?

The operative report should establish that the surgeon excised a pancreatic cyst and describe its location and the tissue removed. Documentation of drainage or an internal connection instead supports choosing the corresponding drainage procedure.

Does the 90-day global period include postoperative care?

Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.

Can modifier 50 be reported?

No. Modifier 50 is inappropriate for this procedure because the pancreatic anatomy is not treated as a paired site for bilateral adjustment.

Can an assistant or co-surgeon be reported?

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

What happens when another procedure is performed in the same session?

Medicare pays the highest-valued procedure in full and reduces the other procedure or procedures to 50% under the standard multiple procedure rule.

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 48500PPRRVU2026_Oct_nonQPP.csv, line 5,748 (RVU26D)

Open CMS sourceHow we calculate rates

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