Billing code 48153: PancreaticoduodenectomyMedicare rate & RVUs in Guam
Reports a major proximal pancreatic resection with duodenal and partial gastric removal, biliary-enteric connection, and the reconstruction specified for this code.
CMS doesn’t publish an office rate for 48153 in Guam.
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 48153 covers
This code represents a Whipple-type operation: the surgeon removes the proximal pancreas along with the duodenum and part of the stomach, creates a connection between the bile duct and intestine, and performs the pancreatic and gastrointestinal reconstruction specified by the code. It is generally performed by a pancreatic or hepatopancreatobiliary surgeon in a hospital operating room for conditions such as a resectable pancreatic-head or periampullary tumor. The operative report should establish the structures removed and the reconstruction performed.
Select this code by matching the documented procedure and reconstruction to the applicable pancreaticoduodenectomy code, rather than relying on the diagnosis alone. Report the completed operation once; do not separately report a component already included in the coded procedure. Medicare assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. When other 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-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.
48153 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $2,770.84 |
How the 48153 rate is calculated
Each of 48153’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 · 48153
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 51.47Practice expense 20.90Malpractice 13.34
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 48153
48153 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 48153
Pancreaticoduodenectomy
| 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 · 48153
Pancreaticoduodenectomy
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
48153 without 51 · national facility
$2,862.79
Pancreaticoduodenectomy
48153-51 · Second procedure: 50%
$1,431.40
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%).
48153 compared with similar codes
Compare codes
48153 vs 48150 vs 48152 vs 48155: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 48150Whipple procedure
- Both are in the pancreaticoduodenectomy family. Choose by matching the operative report’s resection and reconstruction details to the code-specific requirements.
- 48152Pancreatectomy
- This is a neighboring pancreaticoduodenectomy option. The documented operative configuration, not the tumor site alone, distinguishes the codes.
- 48155Pancreatectomy
- 48155 represents total pancreatectomy. This code is for the specified proximal pancreaticoduodenectomy rather than removal of the entire pancreas.
48153 billing questions
How do I distinguish this code from nearby pancreaticoduodenectomy codes?
Compare the operative report with the reconstruction and other procedural details specified by each code in the family. The diagnosis or the label “Whipple” alone does not establish which code applies.
Can the reconstruction be reported separately?
Do not separately report a reconstruction that is included in the procedure represented by this code. Check the operative details before considering any separately documented service.
Does this code have a 90-day global period?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant surgeon or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Should modifier 50 be appended?
No. The CMS bilateral adjustment does not apply to this procedure, and modifier 50 is inappropriate.
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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