CPT code 48520: Cystogastrostomy2026 Medicare rate & RVUs in Nebraska
Reports operative internal drainage of a pancreatic cyst into the stomach by creating a direct communication between the cyst cavity and gastric lumen.
CMS doesn’t publish an office rate for 48520 in Nebraska.
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 48520 covers
This service creates a drainage pathway from a pancreatic cyst or pseudocyst into the stomach. The surgeon opens the cyst cavity and stomach and joins them so the collection can drain internally. It is typically performed by a general or pancreatic surgeon in an operative setting for a collection suitable for drainage into the stomach; the key distinction is the stomach as the drainage destination.
Report 48520 when the operative work creates this cyst-to-stomach connection, rather than simply draining the collection or connecting it to another part of the bowel. The operative report should identify the pancreatic cyst or pseudocyst, the stomach, and the completed anastomosis. 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
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.
48520 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $914.01 |
How the 48520 rate is calculated
Each of 48520’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 · 48520
RVUs × geographic indexes × conversion factor
Work17.70
17.70 RVUs× 1.000 GPCI
Practice expense8.53
8.53 RVUs× 1.000 GPCI
Malpractice4.74
4.74 RVUs× 1.000 GPCI
Adjusted RVUs
30.9700
Conversion factor
$33.4009
Medicare rate
$1,034.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 48520
48520 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 48520
Cystogastrostomy
| 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 · 48520
Cystogastrostomy
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
48520 without 51 · national facility
$1,034.43
Cystogastrostomy
48520-51 · Second procedure: 50%
$517.22
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%).
48520 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 48540Pancreatic cyst drainage
- Choose 48520 when the cyst is joined to the stomach. Choose 48540 when the documented anastomosis is to intestine.
- 48510Pseudocyst drainage
- 48510 represents pancreatic pseudocyst drainage. 48520 specifically represents internal drainage through an anastomosis to the stomach.
- 48548Pancreatic anastomosis
- 48548 connects the pancreas to intestine; 48520 connects a cyst cavity to the stomach. The structure joined and destination differ.
48520 billing questions
How is 48520 different from 48540?
48520 connects the pancreatic cyst to the stomach. 48540 connects it to intestine, so the operative report's drainage destination determines the choice.
When would 48510 be considered instead?
48510 describes drainage of a pancreatic pseudocyst without the cyst-to-stomach anastomosis represented by 48520. Use the documented operative method to distinguish them.
What should the operative report document?
It should identify the pancreatic cyst or pseudocyst, the stomach as the destination, and creation of the communication between the two.
Does 48520 have a Medicare global period?
Yes. It has 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-surgeon payment requires supporting documentation; team surgery is not permitted.
Should modifier 50 be used?
No. The bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
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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