No office rate
This code is for a proximal Whipple-type operation with duodenectomy and pancreatic-to-jejunal reconstruction; 48140 describes a distal partial pancreatectomy.
On this page
CMS RVU26D · Effective 2026-10-01
48150 Whipple procedure Medicare reimbursement rates in Maine
Reports a Whipple-type operation removing the proximal pancreas and duodenum, with pancreatic drainage reconstructed to the jejunum, often for pancreatic head or periampullary disease. Compare 48150 office and facility rates across CMS payment localities in Maine.
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 48150 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2650.52–$2705.43
2 of 2 localities have a supported rate.
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 48150: Proximal pancreaticoduodenectomy with reconstruction
Reports a Whipple-type operation removing the proximal pancreas and duodenum, with pancreatic drainage reconstructed to the jejunum, often for pancreatic head or periampullary disease.
This code describes a major Whipple-type resection in which the proximal pancreas and duodenum are removed and pancreatic drainage is connected to the jejunum. It is commonly performed by a pancreatic or hepatopancreatobiliary surgeon for pancreatic head cancer, ampullary tumors, or other disease requiring this extent of resection. The operation takes place in a surgical facility and includes the reconstruction specified by the code; it is more extensive than removing a pancreatic lesion alone.
Select the code from the operative report’s resection extent and reconstruction, not simply the diagnosis. Documentation should identify the portions of pancreas and duodenum removed and the pancreatic-to-jejunal reconstruction. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery billing is not permitted. Modifier 50 is inappropriate for this procedure.
CMS billing rules for 48150
- 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 RVU51.52 · 60%
- Practice expense (office) RVU21.52 · 25%
- Malpractice RVU12.92 · 15%
3.1K
Medicare services in 2024 · #2141 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.
48150 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
Both involve partial pancreatic resection, but 48145 is a distal resection. Use this code for the proximal Whipple-type operation described in the operative report.
No office rate
48146 describes total pancreatectomy. This code is for a proximal resection that preserves pancreatic tissue outside the resected portion.
No office rate
48120 describes removal of a pancreatic lesion; this code represents the broader proximal pancreatic and duodenal resection with reconstruction.
Compare 48150 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$2650.52
Southern Maine →
Office / nonfacility
Unavailable
Facility
$2705.43
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48150 billing questions
How is this different from a distal pancreatectomy?
This code describes a proximal Whipple-type resection that includes duodenectomy and pancreatic-to-jejunal reconstruction. Distal pancreatectomy codes describe removal from the body or tail rather than this proximal operation.
Is the pancreatic-to-jejunal reconstruction included?
Yes. The reconstruction is part of the Whipple-type service described by this code; it is not reported separately as a separate service merely because it is documented in the operative report.
Should modifier 50 be appended for a bilateral procedure?
No. Modifier 50 is inappropriate for this procedure because its descriptor and anatomy do not support bilateral reporting.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires documentation supporting the co-surgeon roles; team surgery billing is not permitted.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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 subject to a 50% 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.
5,73848145,,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
5,74348153,,Pancreatectomy,A,,51.47,20.90,NA,20.90,,13.34,85.71,85.71,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,74448154,,Pancreatectomy,A,,47.66,19.95,NA,19.95,,12.76,80.37,80.37,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00