No office rate
Use 48000 for open drainage of a pancreatic cyst. Use 48001 when the documented service is placement of a drain in the pancreas.
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CMS RVU26D · Effective 2026-10-01
48000 Pancreatic cyst drainage Medicare reimbursement rates in Ohio
Reports open surgical drainage of a pancreatic cyst, commonly a pseudocyst, when the surgeon treats it through an abdominal operation. Compare 48000 office and facility rates across CMS payment localities in Ohio.
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 48000 in Ohio?
Ohio has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1711.84
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
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 48000: Open drainage of pancreatic cyst
Reports open surgical drainage of a pancreatic cyst, commonly a pseudocyst, when the surgeon treats it through an abdominal operation.
CPT 48000 represents open surgical drainage of a pancreatic cyst, often a pseudocyst. A surgeon accesses the cyst through an abdominal operation and drains its contents; the specific route and technique depend on the operative plan. This is a facility-based service in typical practice, performed by a surgeon rather than an endoscopist. It describes treating the cyst itself, not merely placing a drain in pancreatic tissue or removing a pancreatic stone.
Select the code when the operative report supports open drainage of a pancreatic cyst. Documentation should identify the cyst, its pancreatic location, the open approach, and the drainage performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. 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. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 48000
- 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 RVU31.15 · 60%
- Practice expense (office) RVU12.82 · 25%
- Malpractice RVU8.33 · 16%
29
Medicare services in 2024 · #5688 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.
48000 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
Use 43240 for endoscopic transmural drainage of a pancreatic pseudocyst; 48000 represents open surgical drainage.
No office rate
48020 describes removal of a pancreatic stone. It is not the code for draining a pancreatic cyst.
Compare 48000 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.
1 of 1 payment localities
Ohio →
Office / nonfacility
Unavailable
Facility
$1711.84
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 48000 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
5,730
- Code
- 48000
- Physician work
- 31.15
- Practice expense
- 12.82
- Malpractice
- 8.33
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 31.15 | × 1.000 | 31.1500 |
| Practice expense | 12.82 | × 0.913 | 11.7047 |
| Malpractice | 8.33 | × 1.008 | 8.3966 |
| Total RVUs | 51.2513 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$1711.84
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 31.15 | 1 |
| Practice expense | 12.82 | 0.913 |
| Malpractice | 8.33 | 1.008 |
(31.15 × 1 + 12.82 × 0.913 + 8.33 × 1.008) × $33.4009 = $1711.84
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
48000 billing questions
How is 48000 different from 48001?
48000 is for open drainage of a pancreatic cyst. 48001 describes placement of a drain in the pancreas, so the operative work documented—not simply the presence of a drain—determines the choice.
Can endoscopic drainage be reported with 48000?
No. 48000 represents open surgical treatment; endoscopic transmural drainage of a pancreatic pseudocyst is represented by 43240 when that service is performed.
What documentation supports 48000?
The operative report should establish that the target was a pancreatic cyst and describe the open approach and drainage performed. A note documenting only drain placement or pancreatic stone removal does not establish this service.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global service. CMS classifies 48000 as major surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure rule, 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.
5,72747801,,Placement bile duct support,A,,17.16,9.72,NA,9.72,,4.19,31.07,31.07,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,72847900,,Suture bile duct injury,A,,21.88,11.13,NA,11.13,,5.85,38.86,38.86,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,72947999,,Unlisted px biliary tract,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,73048000,,Drainage of abdomen,A,,31.15,12.82,NA,12.82,,8.33,52.30,52.30,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,73148001,,Placement of drain pancreas,A,,38.70,14.66,NA,14.66,,10.37,63.73,63.73,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,73248020,,Removal of pancreatic stone,A,,18.61,9.78,NA,9.78,,4.96,33.35,33.35,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,73348100,,Biopsy of pancreas open,A,,14.10,7.61,NA,7.61,,3.56,25.27,25.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703