CPT code 48547: Duodenal exclusion2026 Medicare rate & RVUs in Minnesota

Reports an operation that diverts gastric contents away from the duodenum, commonly to protect a repair during treatment of complex duodenal injury.

CMS RVU26DEffective Oct 1, 20261 payment locality26 Medicare services in 2024

CMS doesn’t publish an office rate for 48547 in Minnesota.

—Office (non-facility)
$1,490.48Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 48547 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Minnesota
  2. What 48547 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 48547 covers

The surgeon diverts gastric flow away from the duodenum, typically by closing the pyloric outlet and creating a route from the stomach to the small bowel. The operation is used in selected cases of severe duodenal injury, including trauma in which a duodenal repair needs protection; pancreatic injury may also be present. It is performed in the operating room by a surgeon, generally as part of major abdominal surgery.

Report this code when the operative note documents the duodenal-exclusion procedure, not merely a bypass or repair of another organ. The diagnosis alone does not establish that exclusion was performed; documentation should identify the diversion and the operative work. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple 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-surgeons require 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.

48547 in Minnesota

48547 office and facility rates by payment locality
Payment localityOfficeFacility
MinnesotaUnavailable$1,490.48

How the 48547 rate is calculated

Each of 48547’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 · 48547

RVUs × geographic indexes × conversion factor

Work29.62

29.62 RVUs× 1.000 GPCI

Practice expense12.30

12.30 RVUs× 1.000 GPCI

Malpractice7.93

7.93 RVUs× 1.000 GPCI

Adjusted RVUs

49.8500

Conversion factor

$33.4009

Medicare rate

$1,665.03

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 48547

48547 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 48547

Duodenal exclusion

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 48547

Duodenal exclusion

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

48547 without 51 · national facility

$1,665.03

Duodenal exclusion

48547-51 · Second procedure: 50%

$832.52

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%).

When to use modifier 51

48547 compared with similar codes

Compare codes · National

4 codes, side by side

  • 48547

    Duodenal exclusion29.62 wRVU

    Not priced

  • 43820

    Gastrojejunostomy21.97 wRVU

    Not priced

  • 48545

    Pancreas repair21.67 wRVU

    Not priced

  • 48150

    Whipple procedure51.52 wRVU

    Not priced

How to choose

43820Gastrojejunostomy
A gastrojejunostomy creates a stomach-to-small-bowel connection. Report duodenal exclusion only when the operation also diverts flow away from the duodenum.
48545Pancreas repair
Pancreatorrhaphy describes repair of the pancreas. Duodenal exclusion describes diversion of gastric flow; both may be performed when injuries involve both structures.
48150Whipple procedure
This code describes pancreaticoduodenectomy, a resection operation involving the pancreatic head and duodenum. Duodenal exclusion is a diversion procedure rather than that resection.

48547 billing questions

How is duodenal exclusion different from a gastrojejunostomy alone?

Duodenal exclusion diverts flow away from the duodenum as an operative strategy; a gastrojejunostomy alone describes a connection between the stomach and small bowel. Use this code only when the documented operation includes exclusion.

Can a pancreatic repair be reported during the same operation?

A separately performed pancreatic repair may be reported when the operative record supports that distinct work. The duodenal-exclusion code does not, by itself, describe pancreatic repair.

What documentation supports reporting this code?

The operative report should identify the duodenal diversion and the steps performed, rather than relying only on a diagnosis of duodenal trauma or injury.

Does the code have a postoperative global period?

Yes. CMS assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

How does the multiple procedure rule affect payment?

When this operation and other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard multiple procedure 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 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
RVUs for 48547PPRRVU2026_Oct_nonQPP.csv, line 5,753 (RVU26D)
Geographic factors for MinnesotaGPCI2026.csv, line 66 (RVU26D)

Open CMS sourceHow we calculate rates

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