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CMS RVU26D · Effective 2026-10-01

48155 Pancreatectomy Medicare reimbursement rates in Michigan

Reports surgical removal of the entire pancreas for disease requiring total gland resection, rather than a limited lesion excision or partial pancreatectomy. Compare 48155 office and facility rates across CMS payment localities in Michigan.

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 48155 in Michigan?

Michigan 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

$1698.59–$1860.68

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $162.09 per service.

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.

Find 48155 in your payment locality →

Pancreatic surgery

About 48155: Complete surgical removal of the pancreas

Reports surgical removal of the entire pancreas for disease requiring total gland resection, rather than a limited lesion excision or partial pancreatectomy.

Code 48155 represents removal of the entire pancreas, rather than excision of a focal lesion or resection of only part of the gland. An HPB or general surgeon typically performs this major abdominal operation in a hospital for disease requiring removal of the whole pancreas, such as diffuse pancreatic neoplasia or otherwise extensive pancreatic disease. The operative report should establish that the resection was total.

Report the procedure based on the extent documented in the operative note; a partial resection or limited lesion excision belongs to a different procedure code. The 90-day global package includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, Medicare pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others. Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, while team surgery is not permitted. Modifier 50 is inappropriate for this procedure.

CMS billing rules for 48155

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 RVU28.71 · 56%
  • Practice expense (office) RVU15.24 · 30%
  • Malpractice RVU7.29 · 14%

150

Medicare services in 2024 · #4565 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.

48155 compared with similar codes

Office rates for Michigan, from the same CMS release.

48140

Pancreas resection

Distal, without pancreaticojejunostomy

No office rate

48140 describes partial distal pancreatectomy without pancreaticojejunostomy. Choose 48155 only when the operative report documents removal of the entire pancreas.

48145

Pancreatectomy

Distal resection with jejunal anastomosis

No office rate

48145 describes partial distal pancreatectomy with pancreaticojejunostomy. It is not the code for a total pancreatectomy.

48160

Pancreas removal/transplant

No office rate

48160 includes autologous transplantation of pancreatic tissue or islet cells with the pancreatectomy; 48155 describes total pancreatic removal without that transplant service.

48120

Pancreatic lesion excision

Open local removal

No office rate

48120 is for excision of a pancreatic lesion, not removal of the entire gland. Base selection on the documented extent of resection.

Compare 48155 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

Office and facility base rates · shared scale starting at $0

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48155 billing questions

How does 48155 differ from a partial pancreatectomy code?

Use 48155 when the operative report documents removal of the entire pancreas. Codes for partial pancreatectomy describe removal of only a portion of the gland.

Can a focal pancreatic lesion excision be reported as 48155?

No. A limited lesion excision, such as removal of a localized pancreatic lesion, is distinct from removal of the entire gland.

What postoperative care is included in the global period?

The 90-day global package includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

Should modifier 50 be appended?

No. The bilateral adjustment does not apply, and modifier 50 is inappropriate for this procedure.

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.

RVUs for 48155PPRRVU2026_Oct_nonQPP.csv, line 5,745 (RVU26D)