Billing code 48540: Pancreatic cyst drainageMedicare rate & RVUs in Florida
Reports surgical internal drainage of a pancreatic cyst into the jejunum, commonly used for a pancreatic pseudocyst selected for cystojejunostomy.
CMS doesn’t publish an office rate for 48540 in Florida.
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 9 sections
What 48540 covers
In this operation, the surgeon creates an internal opening between a pancreatic cyst, commonly a pseudocyst, and the jejunum so the collection can drain into the bowel. It is performed by a general or pancreatic surgeon in an operative facility when the cyst’s location and clinical circumstances support jejunal drainage. The operative report should identify the cyst or collection and document the jejunal connection and drainage procedure performed.
Report 48540 for cyst-to-jejunum drainage, not for connecting the pancreatic duct or pancreatic tissue to the jejunum. CMS assigns major-surgery payment with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. 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 48540 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $1,378.93 |
| Miami | Unavailable | $1,525.50 |
| Rest Of Florida | Unavailable | $1,302.71 |
How the 48540 rate is calculated
Each of 48540’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 · 48540
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.39Practice expense 9.43Malpractice 5.72
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 48540
48540 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 48540
Pancreatic cyst drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 48540
Pancreatic cyst drainage
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
48540 without 51 · national facility
$1,220.47
Pancreatic cyst drainage
48540-51 · Second procedure: 50%
$610.24
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%).
48540 compared with similar codes
Compare codes
48540 vs 48520 vs 48510 vs 48548: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 48520Cystogastrostomy
- Choose 48540 when the cyst is connected to the jejunum; choose 48520 when it is connected to the stomach.
- 48510Pseudocyst drainage
- 48510 describes pancreatic pseudocyst drainage without specifying the cyst-to-jejunum connection reported by 48540.
- 48548Pancreatic anastomosis
- 48548 is for a pancreas-to-jejunum connection, not an anastomosis from a pancreatic cyst or pseudocyst to the jejunum.
48540 billing questions
How does 48540 differ from 48520?
48540 connects the pancreatic cyst to the jejunum. 48520 is used when the cyst is connected to the stomach.
Is 48540 used for a direct pancreaticojejunostomy?
No. It describes drainage of a cyst into the jejunum; a connection from the pancreas itself to the jejunum is a different operation, such as 48548.
What documentation supports reporting 48540?
The operative report should establish the pancreatic cyst or collection and document its internal connection to the jejunum for drainage.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code’s anatomy.
How are assistant and co-surgeon services treated?
An assistant at surgery may be paid. 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
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