CPT 48140 Distal Pancreatectomy Reimbursement | OpenPayer

Summary & Overview

CPT 48140: Distal Pancreatectomy, With or Without Splenectomy

CPT code 48140 represents a distal pancreatectomy — surgical removal of the distal portion of the pancreas, performed with or without splenectomy, without reconstruction of pancreatic drainage into the jejunum. This code is used for definitive surgical management of lesions, trauma, or other conditions localized to the pancreatic body or tail and is nationally relevant due to its role in cancer care pathways, complex surgical resource use, and postoperative management.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical indications and typical sites of service, payer coverage considerations, and commonly associated surgical modifiers and billing practices. The publication provides benchmarks and policy context relevant to hospitals and surgical providers, including utilization patterns, coding guidance where available, and areas where payer policy can affect authorization and payment processes.

The content is intended for a national audience of coding professionals, surgical teams, revenue cycle managers, and policy analysts seeking an authoritative summary of CPT code 48140, its clinical context, and the practical billing considerations that commonly arise with distal pancreatectomy procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicarecpt-48140distal-pancreatectomypancreas-surgerygeneral-surgeryinpatient-surgerysurgical-codingoperating-roomsplenectomyprocedure-coding

Billing Code Overview

CPT code 48140 describes the removal of the distal portion of the pancreas, performed with or without concurrent splenectomy. The procedure does not include reconstruction by attaching the pancreatic remnant to the jejunum; in other words, the pancreatic duct is not anastomosed to the small intestine to restore pancreatic enzyme flow.

Service type: Surgical procedure — distal pancreatectomy
Typical site of service: Inpatient or outpatient hospital surgical setting, including operating room; may occur in an ambulatory surgery center for selected cases

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with a 3-month history of worsening left upper quadrant pain, weight loss, and new-onset diabetes is evaluated after imaging reveals a 3.5 cm mass in the distal (body/tail) portion of the pancreas. Endoscopic ultrasound with biopsy confirms a resectable pancreatic neuroendocrine tumor. The surgical team schedules a distal pancreatectomy, with planned removal of the distal pancreas and spleen due to tumor proximity to the splenic hilum. The patient is admitted to an inpatient surgical unit on the day of surgery. Perioperative workflow includes preoperative assessment (medical optimization and informed consent), anesthesia evaluation, intraoperative reporting of the procedure 48140 (distal pancreatectomy, with or without splenectomy), immediate postoperative recovery in PACU, and inpatient postoperative care including pain control, glycemic monitoring, drain management, and discharge planning with outpatient follow-up.

Coding Specifications

Modifier	Description	When to Use
`00`	Default or unmodified service indicator	Rarely used; typically not reported by clinicians — system-level placeholder
`11`

CPT 48100: Open Surgical Biopsy of Pancreatic Lesion

CPT-48102-PERCUTANEOUS-PANCREATIC-NEEDLE-BIOPSY-PATHOLOGY

CPT 48102: Percutaneous Pancreatic Needle Biopsy, Tissue for Pathology

CPT-48152-SUBTOTAL-PANCREATECTOMY-DUODENECTOMY-WITH-RECONSTRUCTION-NO-PANCREATICOJEJUNOSTOMY

CPT 48152: Subtotal Pancreatectomy with Duodenectomy and Reconstruction

CPT-48155-TOTAL-PANCREATECTOMY-COMPLETE-PANCREAS-REMOVAL

CPT 48155: Total Pancreatectomy, Complete Removal of Pancreas

CPT-48146-NEAR-TOTAL-PANCREATECTOMY

CPT 48146: Near Total Pancreatectomy, Major Abdominal Surgery

CPT-48105-PANCREATIC-RESECTION-DEBRIDEMENT-ACUTE-NECROTIZING-PANCREATITIS

CPT 48105: Pancreatic Resection and Debridement for Acute Necrotizing Pancreatitis

CPT-48154-PANCREATIC-DUODENAL-RESECTION-BILIARY-ENTERIC-RECONSTRUCTION

CPT 48154: Partial Pancreas and Duodenum Resection with Biliary‑Enteric Reconstruction

CPT-48145-DISTAL-PANCREATECTOMY-WITH-OR-WITHOUT-SPLENECTOMY

CPT 48145: Distal Pancreatectomy With or Without Splenectomy

CPT-48120-PANCREATIC-LESION-EXCISION

CPT 48120: Excision of Pancreatic Lesion

CPT-48150-PANCREATICODUODENECTOMY-PYLORUS-RESECTING

CPT 48150: Pancreaticoduodenectomy with Distal Stomach Resection

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Taxonomy Code	Specialty	Notes
207LX0000X	General Surgery	General surgeons with HPB focus commonly perform distal pancreatectomy
2080P0200X	Surgical Oncology	Surgical oncologists often perform pancreatic resections for neoplasms
2084P0800X	Colon & Rectal Surgery (HPB overlap)	HPB-trained colorectal surgeons may assist in complex abdominal resections
2080S0125X	Hepatology (Surgical) / Hepatopancreatobiliary Surgery	HPB surgeons specializing in liver and pancreatic surgery perform distal pancreatectomy
364S00000X	Anesthesiology	Anesthesia providers are integral to operative and perioperative management

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C25.7`	Malignant neoplasm of pancreas, tail	Common indication for distal pancreatectomy when tumor is located in the tail of the pancreas
`C25.9`	Malignant neoplasm of pancreas, unspecified	Used when site is not otherwise specified but resection is performed for pancreatic malignancy
`D37.4`	Neoplasm of uncertain behavior of pancreas	Used for lesions with uncertain malignant potential where surgical excision is performed for diagnosis/treatment
`K86.2`	Cyst of pancreas	Symptomatic or suspicious pancreatic cysts in the body/tail may prompt distal pancreatectomy
`K86.89`	Other specified diseases of pancreas (e.g., chronic pancreatitis complications)	Chronic pancreatitis with localized disease in the tail may require distal resection for pain or complications

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`48140`	Distal pancreatectomy; removal of the distal portion of the pancreas with or without splenectomy	Primary procedure for resection of lesions in the body and tail of the pancreas (this code)
`38100`	Splenectomy, total, for any reason (separate procedure code)	Report when a formal splenectomy is performed concurrently and payer requires separate reporting from pancreatic resection
`47562`	Laparoscopy, surgical; distal pancreatectomy (including spleen when performed)	Report when the distal pancreatectomy is performed laparoscopically — use the laparoscopic-specific code if applicable
`44320`	Resection or excision of lesion of small intestine; may be reported for concurrent enteric procedures	Report if bowel resection or enteric reconstruction is required during the same operative session
`49999`	Unlisted procedure, abdomen, peritoneum and omentum	Use only when a performed service does not have an available CPT code (rare; typically not applicable for standard distal pancreatectomy)

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