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CPT 48120: Excision of Pancreatic Lesion
CPT code 48120 represents surgical removal of a lesion of the pancreas — a focused operative procedure used for diagnostic and therapeutic management of pancreatic masses. Nationally, pancreatic surgery is clinically significant due to the complex perioperative needs, potential for malignancy, and resource intensity of care. This code captures discrete lesion excision distinct from more extensive pancreatic resections.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical role, typical site-of-service settings, and which national payers commonly process claims for this service. The publication provides benchmarks and comparative coverage context, highlights clinical considerations tied to operative management of pancreatic lesions, and summarizes relevant coding relationships and utilization patterns where available.
The coverage will help billing managers, surgical practices, and policy analysts understand how CPT code 48120 is used in claims, what to expect from major payers, and where to look for additional policy or reimbursement detail. Data not available in the input will be noted explicitly in relevant sections.
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Billing Code Overview
CPT code 48120 describes a procedure in which the provider removes a lesion of the pancreas. This service is a surgical excision of a pancreatic lesion, typically performed to diagnose or treat focal pancreatic masses or tumors.
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Service type: Surgical procedure
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Typical site of service: Hospital operating room or surgical suite (inpatient or outpatient surgical setting)