No office rate
A gastrojejunostomy creates a stomach-to-small-bowel connection. Report duodenal exclusion only when the operation also diverts flow away from the duodenum.
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CMS RVU26D · Effective 2026-10-01
48547 Duodenal exclusion Medicare reimbursement rates in Colorado
Reports an operation that diverts gastric contents away from the duodenum, commonly to protect a repair during treatment of complex duodenal injury. Compare 48547 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 48547 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1645.19
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Pancreatic surgery
About 48547: Surgical duodenal exclusion
Reports an operation that diverts gastric contents away from the duodenum, commonly to protect a repair during treatment of complex duodenal injury.
The surgeon diverts gastric flow away from the duodenum, typically by closing the pyloric outlet and creating a route from the stomach to the small bowel. The operation is used in selected cases of severe duodenal injury, including trauma in which a duodenal repair needs protection; pancreatic injury may also be present. It is performed in the operating room by a surgeon, generally as part of major abdominal surgery.
Report this code when the operative note documents the duodenal-exclusion procedure, not merely a bypass or repair of another organ. The diagnosis alone does not establish that exclusion was performed; documentation should identify the diversion and the operative work. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple 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-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 48547
- 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 RVU29.62 · 59%
- Practice expense (office) RVU12.30 · 25%
- Malpractice RVU7.93 · 16%
26
Medicare services in 2024 · #5761 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.
48547 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
Pancreatorrhaphy describes repair of the pancreas. Duodenal exclusion describes diversion of gastric flow; both may be performed when injuries involve both structures.
No office rate
This code describes pancreaticoduodenectomy, a resection operation involving the pancreatic head and duodenum. Duodenal exclusion is a diversion procedure rather than that resection.
Compare 48547 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$1645.19
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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 48547 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
5,753
- Code
- 48547
- Physician work
- 29.62
- Practice expense
- 12.30
- Malpractice
- 7.93
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 29.62 | × 1.012 | 29.9754 |
| Practice expense | 12.30 | × 1.064 | 13.0872 |
| Malpractice | 7.93 | × 0.781 | 6.1933 |
| Total RVUs | 49.2560 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$1645.19
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 29.62 | 1.012 |
| Practice expense | 12.3 | 1.064 |
| Malpractice | 7.93 | 0.781 |
(29.62 × 1.012 + 12.3 × 1.064 + 7.93 × 0.781) × $33.4009 = $1645.19
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.
48547 billing questions
How is duodenal exclusion different from a gastrojejunostomy alone?
Duodenal exclusion diverts flow away from the duodenum as an operative strategy; a gastrojejunostomy alone describes a connection between the stomach and small bowel. Use this code only when the documented operation includes exclusion.
Can a pancreatic repair be reported during the same operation?
A separately performed pancreatic repair may be reported when the operative record supports that distinct work. The duodenal-exclusion code does not, by itself, describe pancreatic repair.
What documentation supports reporting this code?
The operative report should identify the duodenal diversion and the steps performed, rather than relying only on a diagnosis of duodenal trauma or injury.
Does the code have a postoperative global period?
Yes. CMS assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
How does the multiple procedure rule affect payment?
When this operation and other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard multiple procedure reduction.
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.
5,75048520,,Fuse pancreas cyst and bowel,A,,17.70,8.53,NA,8.53,,4.74,30.97,30.97,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,75148540,,Fuse pancreas cyst and bowel,A,,21.39,9.43,NA,9.43,,5.72,36.54,36.54,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,75248545,,Pancreatorrhaphy,A,,21.67,10.38,NA,10.38,,5.78,37.83,37.83,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,75348547,,Duodenal exclusion,A,,29.62,12.30,NA,12.30,,7.93,49.85,49.85,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,75448548,,Fuse pancreas and bowel,A,,27.39,11.90,NA,11.90,,7.33,46.62,46.62,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,75548550,,Donor pancreatectomy,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,75648551,,Prep donor pancreas,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899