Billing code 48500: Pancreatic surgeryMedicare rate & RVUs in Utah
Reports surgical removal of a pancreatic cyst, rather than drainage or creation of an internal drainage connection, when excision is the operation performed.
CMS doesn’t publish an office rate for 48500 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 48500 covers
This service is the surgical excision of a cyst arising in the pancreas. A surgeon performs it in an operating room when the operative plan is to remove the cyst, rather than simply drain its contents or connect it to the stomach or intestine. The operative report should identify the cyst’s location and describe the tissue removed and the procedure performed.
Report 48500 when the operation is cyst excision; use a drainage or anastomosis code when that is the procedure performed. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate for this pancreatic procedure. Assistant-at-surgery payment may be allowed; co-surgeon payment requires 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.
48500 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $1,055.21 |
How the 48500 rate is calculated
Each of 48500’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 · 48500
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.71Practice expense 10.24Malpractice 4.74
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 48500
48500 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 48500
Pancreatic surgery
| 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 · 48500
Pancreatic surgery
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
48500 without 51 · national facility
$1,091.88
Pancreatic surgery
48500-51 · Second procedure: 50%
$545.94
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%).
48500 compared with similar codes
Compare codes
48500 vs 48510 vs 48520 vs 48540 vs 48120: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 48510Pseudocyst drainage
- Use 48500 for excision of the cyst; 48510 describes drainage of a pancreatic pseudocyst.
- 48520Cystogastrostomy
- Use 48520 when the procedure connects a pancreatic cyst to the stomach for internal drainage, rather than excising the cyst.
- 48540Pancreatic cyst drainage
- Use 48540 for internal drainage by connecting the pancreatic cyst to intestine; 48500 is for excision.
- 48120Pancreatic lesion excision
- 48120 describes open excision of a pancreatic lesion, which may include a cyst. Select the code that matches the documented operation and applicable procedure description.
48500 billing questions
How is cyst excision different from pancreatic cyst drainage?
Use 48500 when the surgeon removes the cyst. For drainage without excision, consider 48510; for internal drainage through an anastomosis, consider 48520 or 48540, as applicable.
What documentation supports reporting 48500?
The operative report should establish that the surgeon excised a pancreatic cyst and describe its location and the tissue removed. Documentation of drainage or an internal connection instead supports choosing the corresponding drainage procedure.
Does the 90-day global period include postoperative care?
Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this procedure because the pancreatic anatomy is not treated as a paired site for bilateral adjustment.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Medicare pays the highest-valued procedure in full and reduces the other procedure or procedures to 50% under the standard multiple procedure rule.
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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