No office rate
Use 48146 when pancreaticojejunostomy is performed with the distal subtotal resection; 48145 describes the corresponding operation without it.
On this page
CMS RVU26D · Effective 2026-10-01
48146 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1768.79
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Pancreatic surgery
About 48146: Distal subtotal pancreatectomy with reconstruction
Report this code for distal subtotal removal of the pancreas when the surgeon reconnects the remaining pancreatic tissue to the jejunum.
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.
CMS billing rules for 48146
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU29.84 · 56%
- Practice expense (office) RVU15.11 · 29%
- Malpractice RVU7.98 · 15%
75
Medicare services in 2024 · #5104 by national volume
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.
48146 compared with similar codes
Office rates for Austin, from the same CMS release.
No office rate
48140 describes a different distal partial pancreatectomy service. Use 48146 when the documented operation is distal subtotal resection with pancreaticojejunostomy.
No office rate
48150 is for a proximal subtotal pancreatic resection, while 48146 is for distal subtotal resection with pancreaticojejunostomy.
The same code, a different location
How does Austin compare?
48146 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 48146
Office
Unavailable
Facility
$1716.32
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 48146
Office
Unavailable
Facility
$1811.57
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 48146
Office
Unavailable
Facility
$1941.68
No comparable office rate is available.
Miami
Florida · 48146
Office
Unavailable
Facility
$2196.14
No comparable office rate is available.
Chicago
Illinois · 48146
Office
Unavailable
Facility
$2122.58
No comparable office rate is available.
Manhattan
New York · 48146
Office
Unavailable
Facility
$2069.65
No comparable office rate is available.
Alaska*
Alaska · 48146
Office
Unavailable
Facility
$2179.38
No comparable office rate is available.
Alabama
Alabama · 48146
Office
Unavailable
Facility
$1589.15
No comparable office rate is available.
Arkansas
Arkansas · 48146
Office
Unavailable
Facility
$1567.48
No comparable office rate is available.
Arizona
Arizona · 48146
Office
Unavailable
Facility
$1713.88
No comparable office rate is available.
Bakersfield
California · 48146
Office
Unavailable
Facility
$1731.08
No comparable office rate is available.
Chico
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
El Centro
California · 48146
Office
Unavailable
Facility
$1710.96
No comparable office rate is available.
Fresno
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
Hanford-Corcoran
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
Madera
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
Merced
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
Modesto
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
Napa
California · 48146
Office
Unavailable
Facility
$1860.05
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 48146
Office
Unavailable
Facility
$1787.18
No comparable office rate is available.
Redding
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
Rest Of California
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 48146
Office
Unavailable
Facility
$1795.12
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 48146
Office
Unavailable
Facility
$1762.38
No comparable office rate is available.
Salinas
California · 48146
Office
Unavailable
Facility
$1755.38
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 48146
Office
Unavailable
Facility
$1774.65
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 48146
Office
Unavailable
Facility
$1925.32
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 48146
Office
Unavailable
Facility
$1916.26
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 48146
Office
Unavailable
Facility
$1976.94
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 48146
Office
Unavailable
Facility
$1939.89
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 48146
Office
Unavailable
Facility
$1731.33
No comparable office rate is available.
Santa Cruz-Watsonville
California · 48146
Office
Unavailable
Facility
$1773.67
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 48146
Office
Unavailable
Facility
$1755.92
No comparable office rate is available.
Santa Rosa-Petaluma
California · 48146
Office
Unavailable
Facility
$1789.20
No comparable office rate is available.
Stockton
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
Vallejo
California · 48146
Office
Unavailable
Facility
$1846.99
No comparable office rate is available.
Visalia
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
Yuba City
California · 48146
Office
Unavailable
Facility
$1709.63
No comparable office rate is available.
Colorado
Colorado · 48146
Office
Unavailable
Facility
$1753.80
No comparable office rate is available.
Connecticut
Connecticut · 48146
Office
Unavailable
Facility
$1882.68
No comparable office rate is available.
Delaware
Delaware · 48146
Office
Unavailable
Facility
$1739.92
No comparable office rate is available.
Fort Lauderdale
Florida · 48146
Office
Unavailable
Facility
$1989.83
No comparable office rate is available.
Rest Of Florida
Florida · 48146
Office
Unavailable
Facility
$1879.77
No comparable office rate is available.
Atlanta
Georgia · 48146
Office
Unavailable
Facility
$1832.55
No comparable office rate is available.
Rest Of Georgia
Georgia · 48146
Office
Unavailable
Facility
$1764.58
No comparable office rate is available.
Hawaii, Guam
Hawaii · 48146
Office
Unavailable
Facility
$1724.84
No comparable office rate is available.
Iowa
Iowa · 48146
Office
Unavailable
Facility
$1564.29
No comparable office rate is available.
Idaho
Idaho · 48146
Office
Unavailable
Facility
$1587.07
No comparable office rate is available.
East St. Louis
Illinois · 48146
Office
Unavailable
Facility
$1997.81
No comparable office rate is available.
Rest Of Illinois
Illinois · 48146
Office
Unavailable
Facility
$1874.06
No comparable office rate is available.
Suburban Chicago
Illinois · 48146
Office
Unavailable
Facility
$1994.28
No comparable office rate is available.
Indiana
Indiana · 48146
Office
Unavailable
Facility
$1594.07
No comparable office rate is available.
Kansas
Kansas · 48146
Office
Unavailable
Facility
$1587.26
No comparable office rate is available.
Kentucky
Kentucky · 48146
Office
Unavailable
Facility
$1689.23
No comparable office rate is available.
New Orleans
Louisiana · 48146
Office
Unavailable
Facility
$1774.38
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 48146
Office
Unavailable
Facility
$1698.68
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 48146
Office
Unavailable
Facility
$1877.36
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 48146
Office
Unavailable
Facility
$1756.50
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 48146
Office
Unavailable
Facility
$1883.87
No comparable office rate is available.
Rest Of Maryland
Maryland · 48146
Office
Unavailable
Facility
$1762.08
No comparable office rate is available.
Rest Of Maine
Maine · 48146
Office
Unavailable
Facility
$1626.78
No comparable office rate is available.
Southern Maine
Maine · 48146
Office
Unavailable
Facility
$1665.01
No comparable office rate is available.
Detroit
Michigan · 48146
Office
Unavailable
Facility
$1933.09
No comparable office rate is available.
Rest Of Michigan
Michigan · 48146
Office
Unavailable
Facility
$1758.39
No comparable office rate is available.
Minnesota
Minnesota · 48146
Office
Unavailable
Facility
$1594.90
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 48146
Office
Unavailable
Facility
$1730.99
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 48146
Office
Unavailable
Facility
$1744.22
No comparable office rate is available.
Rest Of Missouri
Missouri · 48146
Office
Unavailable
Facility
$1691.33
No comparable office rate is available.
Mississippi
Mississippi · 48146
Office
Unavailable
Facility
$1628.19
No comparable office rate is available.
Montana**
Montana · 48146
Office
Unavailable
Facility
$1767.38
No comparable office rate is available.
North Carolina
North Carolina · 48146
Office
Unavailable
Facility
$1637.87
No comparable office rate is available.
North Dakota**
North Dakota · 48146
Office
Unavailable
Facility
$1609.59
No comparable office rate is available.
Nebraska
Nebraska · 48146
Office
Unavailable
Facility
$1563.26
No comparable office rate is available.
New Hampshire
New Hampshire · 48146
Office
Unavailable
Facility
$1755.28
No comparable office rate is available.
Northern Nj
New Jersey · 48146
Office
Unavailable
Facility
$1929.58
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 48146
Office
Unavailable
Facility
$1880.06
No comparable office rate is available.
New Mexico
New Mexico · 48146
Office
Unavailable
Facility
$1779.59
No comparable office rate is available.
Nevada**
Nevada · 48146
Office
Unavailable
Facility
$1723.90
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 48146
Office
Unavailable
Facility
$2155.51
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 48146
Office
Unavailable
Facility
$1916.68
No comparable office rate is available.
Queens
New York · 48146
Office
Unavailable
Facility
$2041.36
No comparable office rate is available.
Rest Of New York
New York · 48146
Office
Unavailable
Facility
$1663.51
No comparable office rate is available.
Ohio
Ohio · 48146
Office
Unavailable
Facility
$1726.13
No comparable office rate is available.
Oklahoma
Oklahoma · 48146
Office
Unavailable
Facility
$1654.47
No comparable office rate is available.
Portland
Oregon · 48146
Office
Unavailable
Facility
$1771.64
No comparable office rate is available.
Rest Of Oregon
Oregon · 48146
Office
Unavailable
Facility
$1686.73
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 48146
Office
Unavailable
Facility
$1857.98
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 48146
Office
Unavailable
Facility
$1711.87
No comparable office rate is available.
Puerto Rico
Puerto Rico · 48146
Office
Unavailable
Facility
$1769.46
No comparable office rate is available.
Rhode Island
Rhode Island · 48146
Office
Unavailable
Facility
$1774.72
No comparable office rate is available.
South Carolina
South Carolina · 48146
Office
Unavailable
Facility
$1689.57
No comparable office rate is available.
South Dakota**
South Dakota · 48146
Office
Unavailable
Facility
$1590.93
No comparable office rate is available.
Tennessee
Tennessee · 48146
Office
Unavailable
Facility
$1598.58
No comparable office rate is available.
Utah
Utah · 48146
Office
Unavailable
Facility
$1710.44
No comparable office rate is available.
Virginia
Virginia · 48146
Office
Unavailable
Facility
$1680.97
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 48146
Office
Unavailable
Facility
$1769.46
No comparable office rate is available.
Vermont
Vermont · 48146
Office
Unavailable
Facility
$1631.19
No comparable office rate is available.
Rest Of Washington
Washington · 48146
Office
Unavailable
Facility
$1743.91
No comparable office rate is available.
Seattle (King Cnty)
Washington · 48146
Office
Unavailable
Facility
$1883.53
No comparable office rate is available.
Wisconsin
Wisconsin · 48146
Office
Unavailable
Facility
$1562.27
No comparable office rate is available.
West Virginia
West Virginia · 48146
Office
Unavailable
Facility
$1816.67
No comparable office rate is available.
Wyoming**
Wyoming · 48146
Office
Unavailable
Facility
$1698.61
No comparable office rate is available.
See how rates vary across the country
48146 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 48146 in Austin
Multiple payment areas
- 48146 in Barton Creek
- 48146 in Bee Cave
- 48146 in Briarcliff
- 48146 in Cedar Park
Multiple payment areas
- 48146 in Creedmoor
Multiple payment areas
- 48146 in Elgin
Multiple payment areas
- 48146 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 48146 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1945.67
$1768.79 × 110% = $1945.67
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 48146 in Austin.
PPRRVU2026_Oct_nonQPP.csv
5,739
- Code
- 48146
- Physician work
- 29.84
- Practice expense
- 15.11
- Malpractice
- 7.98
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 29.84 | × 1.002 | 29.8997 |
| Practice expense | 15.11 | × 1.058 | 15.9864 |
| Malpractice | 7.98 | × 0.886 | 7.0703 |
| Total RVUs | 52.9563 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$1768.79
Open 48146 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 29.84 | 1.002 |
| Practice expense | 15.11 | 1.058 |
| Malpractice | 7.98 | 0.886 |
(29.84 × 1.002 + 15.11 × 1.058 + 7.98 × 0.886) × $33.4009 = $1768.79
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
48146 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1768.79 | RVU26D |
| 2026-07-01 | Not available in this setting | $1768.79 | RVU26C |
| 2026-04-01 | Not available in this setting | $1768.79 | RVU26B |
| 2026-01-01 | Not available in this setting | $1768.79 | RVU26A |
| 2025-10-01 | Not available in this setting | $1839.24 | RVU25D |
| 2025-07-01 | Not available in this setting | $1839.24 | RVU25C |
| 2025-04-01 | Not available in this setting | $1839.24 | RVU25B |
| 2025-01-01 | Not available in this setting | $1839.24 | RVU25A |
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,73648120,,Removal of pancreas lesion,A,,17.95,8.60,NA,8.60,,4.80,31.35,31.35,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,73748140,,Partial removal of pancreas,A,,25.66,11.51,NA,11.51,,6.44,43.61,43.61,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,73848145,,Partial removal of pancreas,A,,26.71,11.75,NA,11.75,,7.14,45.60,45.60,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,73948146,,Pancreatectomy,A,,29.84,15.11,NA,15.11,,7.98,52.93,52.93,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,74048148,,Removal of pancreatic duct,A,,19.88,10.09,NA,10.09,,5.30,35.27,35.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,74148150,,Partial removal of pancreas,A,,51.52,21.52,NA,21.52,,12.92,85.96,85.96,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,74248152,,Pancreatectomy,A,,47.43,19.90,NA,19.90,,12.70,80.03,80.03,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858