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    OpenPayerBilling CodesIncision Procedures on the PancreasCPT cpt-48020-pancreatic-stone-removal
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    CPT 48020: Removal of Pancreatic Stone

    Medicare pays $1123 on average nationally for this procedure.

    CPT code 48020 describes surgical removal of a stone from the pancreas, a procedure performed to extract obstructing pancreatic calculi; service type: pancreatic stone extraction; typical site of service: operating room or procedure suite (inpatient or outpatient surgical setting).

    For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with a history of chronic pancreatitis presents with recurrent epigastric pain, nausea, and radiographic evidence of an obstructing pancreatic duct stone on MRCP. After endoscopic evaluation with ERCP and failed endoscopic fragmentation, the surgical team schedules an operative procedure to remove the pancreatic duct stone. The patient is taken to the operating room, placed under general anesthesia, and monitored by anesthesia and perioperative nursing. The pancreatic duct is exposed via either a pancreaticojejunostomy or direct ductotomy depending on intraoperative findings. The surgeon identifies and extracts the calculus, irrigates the duct, assesses duct patency, and may place a stent if indicated. Hemostasis is secured and the incision closed. Postoperative care includes pain control, monitoring for pancreatic leak or infection, serial abdominal examinations, laboratory evaluation of amylase/lipase, and imaging if complications are suspected. Billing uses 48020 to report removal of a stone from the pancreas when performed surgically.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    47562Laparoscopic cholecystectomy with exploration of common bile duct — when performedMay be performed concurrently if biliary stones or cholelithiasis coexist and intraoperative exploration is required.
    43260Endoscopic retrograde cholangiopancreatography (ERCP) with diagnostic pancreatographyOften performed preoperatively for diagnosis, ductal imaging, and possible endoscopic attempts at stone extraction.
    43264ERCP with removal of pancreatic duct stone by endoscopic methodsEndoscopic alternative or precursor to surgical 48020; may be attempted prior to operative removal.
    48145Pancreaticojejunostomy (Puestow)May be performed in conjunction with ductal stone removal when ductal drainage reconstruction is required.
    49000Exploratory laparotomy, exploratory celiotomy with or without biopsyMay precede definitive ductotomy and stone extraction in open cases.
    47563Open cholecystectomy with exploration of common bile duct — when indicatedPerformed when concomitant biliary surgery is needed during the same operative session.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208100000X
    208600000X
    207L00000X
    207V00000X
    261QU0200X
    363LP1700X
    204R00000X
    213EP1101X

    Related ICD-10-CM Codes

    19 rows

    ICD-10-CM CodeDescription
    B25.9Cytomegaloviral disease, unspecified
    E86.0Dehydration
    K75.0Abscess of liver
    K83.1Obstruction of bile duct
    K83.2Perforation of bile duct
    K83.8Other specified diseases of biliary tract
    K83.9Disease of biliary tract, unspecified
    K86.0Alcohol-induced chronic pancreatitis
    K86.1Other chronic pancreatitis
    K86.3Pseudocyst of pancreas

    Showing 1–10 of 19

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 4

    10 rows

    PolicyPayerEffective Date
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Radiofrequency Therapy for Fecal IncontinenceCigna2026-10-15
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    High-Resolution Anoscopy (HRA)Premera Bluecross2026-10-01
    Gastroesophageal and Gastrointestinal (GI) Services and ProceduresColorado Rocky Mountain Health Plans2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01

    Related Codes

    CPT-48000-PERIPANCREATIC-DRAIN-PLACEMENT-ACUTE-PANCREATITIS

    CPT 48000: Surgical Placement of Drains Around Pancreas

    CPT-48001-PANCREATIC-AND-ENTERIC-DRAINAGE-TUBE-PLACEMENT

    CPT 48001: Pancreatic and Enteric Drainage Tube Placement

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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