48120 Pancreatic lesion excision Medicare reimbursement rates in Kansas

This code describes open surgical removal of a localized pancreatic lesion, such as a cyst or adenoma, while preserving the distinction between local excision and removal of a larger portion of the gland. A general or hepatopancreatobiliary surgeon typically performs the operation in a hospital operating room. The excised tissue may be submitted for pathologic examination. Needle or open biopsy is a different service when the surgeon obtains tissue for diagnosis without removing the lesion.

Select the code from the operative report’s description of the lesion and the extent of pancreatic tissue removed. Documentation should establish that the surgeon excised a localized lesion through an open approach and clarify whether the work instead involved biopsy or partial pancreatectomy. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. CMS may pay for an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.