No office rate
Use 48500 for excision of the cyst; 48510 describes drainage of a pancreatic pseudocyst.
On this page
CMS RVU26D · Effective 2026-10-01
48500 Pancreatic surgery Medicare reimbursement rates in Wyoming
Reports surgical removal of a pancreatic cyst, rather than drainage or creation of an internal drainage connection, when excision is the operation performed. Compare 48500 office and facility rates across CMS payment localities in Wyoming.
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 48500 in Wyoming?
Wyoming 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
$1050.71
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 48500: Pancreatic cyst excision
Reports surgical removal of a pancreatic cyst, rather than drainage or creation of an internal drainage connection, when excision is the operation performed.
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.
CMS billing rules for 48500
- 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 RVU17.71 · 54%
- Practice expense (office) RVU10.24 · 31%
- Malpractice RVU4.74 · 14%
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 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Use 48520 when the procedure connects a pancreatic cyst to the stomach for internal drainage, rather than excising the cyst.
No office rate
Use 48540 for internal drainage by connecting the pancreatic cyst to intestine; 48500 is for excision.
No office rate
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.
Compare 48500 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$1050.71
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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 48500 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,748
- Code
- 48500
- Physician work
- 17.71
- Practice expense
- 10.24
- Malpractice
- 4.74
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.71 | × 1.000 | 17.7100 |
| Practice expense | 10.24 | × 1.000 | 10.2400 |
| Malpractice | 4.74 | × 0.740 | 3.5076 |
| Total RVUs | 31.4576 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1050.71
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.71 | 1 |
| Practice expense | 10.24 | 1 |
| Malpractice | 4.74 | 0.74 |
(17.71 × 1 + 10.24 × 1 + 4.74 × 0.74) × $33.4009 = $1050.71
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.
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 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.
5,74548155,,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
5,74748400,,Injection intraop add-on,A,,1.90,0.46,NA,0.46,,0.49,2.85,2.85,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,74848500,,Surgery of pancreatic cyst,A,,17.71,10.24,NA,10.24,,4.74,32.69,32.69,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,74948510,,Drain pancreatic pseudocyst,A,,16.76,10.01,NA,10.01,,4.48,31.25,31.25,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,75048520,,Fuse pancreas cyst and bowel,A,,17.70,8.53,NA,8.53,,4.74,30.97,30.97,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,75148540,,Fuse pancreas cyst and bowel,A,,21.39,9.43,NA,9.43,,5.72,36.54,36.54,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,