Billing code 48150: Whipple procedureMedicare rate & RVUs in Utah
Reports a Whipple-type operation removing the proximal pancreas and duodenum, with pancreatic drainage reconstructed to the jejunum, often for pancreatic head or periampullary disease.
CMS doesn’t publish an office rate for 48150 in Utah.
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 48150 covers
This code describes a major Whipple-type resection in which the proximal pancreas and duodenum are removed and pancreatic drainage is connected to the jejunum. It is commonly performed by a pancreatic or hepatopancreatobiliary surgeon for pancreatic head cancer, ampullary tumors, or other disease requiring this extent of resection. The operation takes place in a surgical facility and includes the reconstruction specified by the code; it is more extensive than removing a pancreatic lesion alone.
Select the code from the operative report’s resection extent and reconstruction, not simply the diagnosis. Documentation should identify the portions of pancreas and duodenum removed and the pancreatic-to-jejunal reconstruction. 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. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery billing is not permitted. Modifier 50 is inappropriate for this procedure.
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.
48150 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $2,784.00 |
How the 48150 rate is calculated
Each of 48150’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 · 48150
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 51.52Practice expense 21.52Malpractice 12.92
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 48150
48150 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 48150
Whipple procedure
| 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 · 48150
Whipple procedure
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
48150 without 51 · national facility
$2,871.14
Whipple procedure
48150-51 · Second procedure: 50%
$1,435.57
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%).
48150 compared with similar codes
Compare codes
48150 vs 48140 vs 48145 vs 48146 vs 48120: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 48140Pancreas resection
- This code is for a proximal Whipple-type operation with duodenectomy and pancreatic-to-jejunal reconstruction; 48140 describes a distal partial pancreatectomy.
- 48145Pancreatectomy
- Both involve partial pancreatic resection, but 48145 is a distal resection. Use this code for the proximal Whipple-type operation described in the operative report.
- 48146Pancreatectomy
- 48146 describes total pancreatectomy. This code is for a proximal resection that preserves pancreatic tissue outside the resected portion.
- 48120Pancreatic lesion excision
- 48120 describes removal of a pancreatic lesion; this code represents the broader proximal pancreatic and duodenal resection with reconstruction.
48150 billing questions
How is this different from a distal pancreatectomy?
This code describes a proximal Whipple-type resection that includes duodenectomy and pancreatic-to-jejunal reconstruction. Distal pancreatectomy codes describe removal from the body or tail rather than this proximal operation.
Is the pancreatic-to-jejunal reconstruction included?
Yes. The reconstruction is part of the Whipple-type service described by this code; it is not reported separately as a separate service merely because it is documented in the operative report.
Should modifier 50 be appended for a bilateral procedure?
No. Modifier 50 is inappropriate for this procedure because its descriptor and anatomy do not support bilateral reporting.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires documentation supporting the co-surgeon roles; team surgery billing is not permitted.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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 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 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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