No office rate
Both are in the pancreaticoduodenectomy family. Choose by matching the operative report’s resection and reconstruction details to the code-specific requirements.
On this page
CMS RVU26D · Effective 2026-10-01
48153 Pancreaticoduodenectomy Medicare reimbursement rates in Tennessee
Reports a major proximal pancreatic resection with duodenal and partial gastric removal, biliary-enteric connection, and the reconstruction specified for this code. Compare 48153 office and facility rates across CMS payment localities in Tennessee.
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 48153 in Tennessee?
Tennessee 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
$2592.97
1 of 1 localities have a supported rate.
Payment area: Tennessee
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.
General surgery
About 48153: Proximal pancreaticoduodenectomy with reconstruction
Reports a major proximal pancreatic resection with duodenal and partial gastric removal, biliary-enteric connection, and the reconstruction specified for this code.
This code represents a Whipple-type operation: the surgeon removes the proximal pancreas along with the duodenum and part of the stomach, creates a connection between the bile duct and intestine, and performs the pancreatic and gastrointestinal reconstruction specified by the code. It is generally performed by a pancreatic or hepatopancreatobiliary surgeon in a hospital operating room for conditions such as a resectable pancreatic-head or periampullary tumor. The operative report should establish the structures removed and the reconstruction performed.
Select this code by matching the documented procedure and reconstruction to the applicable pancreaticoduodenectomy code, rather than relying on the diagnosis alone. Report the completed operation once; do not separately report a component already included in the coded procedure. Medicare assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. When other 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-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 48153
- 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 RVU51.47 · 60%
- Practice expense (office) RVU20.90 · 24%
- Malpractice RVU13.34 · 16%
1K
Medicare services in 2024 · #2937 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.
48153 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
This is a neighboring pancreaticoduodenectomy option. The documented operative configuration, not the tumor site alone, distinguishes the codes.
No office rate
48155 represents total pancreatectomy. This code is for the specified proximal pancreaticoduodenectomy rather than removal of the entire pancreas.
Compare 48153 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$2592.97
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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 48153 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
5,743
- Code
- 48153
- Physician work
- 51.47
- Practice expense
- 20.90
- Malpractice
- 13.34
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 51.47 | × 1.000 | 51.4700 |
| Practice expense | 20.90 | × 0.909 | 18.9981 |
| Malpractice | 13.34 | × 0.537 | 7.1636 |
| Total RVUs | 77.6317 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$2592.97
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 51.47 | 1 |
| Practice expense | 20.9 | 0.909 |
| Malpractice | 13.34 | 0.537 |
(51.47 × 1 + 20.9 × 0.909 + 13.34 × 0.537) × $33.4009 = $2592.97
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.
48153 billing questions
How do I distinguish this code from nearby pancreaticoduodenectomy codes?
Compare the operative report with the reconstruction and other procedural details specified by each code in the family. The diagnosis or the label “Whipple” alone does not establish which code applies.
Can the reconstruction be reported separately?
Do not separately report a reconstruction that is included in the procedure represented by this code. Check the operative details before considering any separately documented service.
Does this code have a 90-day global period?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant surgeon or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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 paid at 50% when performed in the same session.
Should modifier 50 be appended?
No. The CMS bilateral adjustment does not apply to this procedure, and modifier 50 is inappropriate.
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.
5,74048148,,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
5,74548155,,Removal of pancreas,A,,28.71,15.24,NA,15.24,,7.29,51.24,51.24,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,74648160,,Pancreas removal/transplant,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780