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CPT 48150: Pancreaticoduodenectomy with Distal Stomach Resection
CPT code 48150 represents a major pancreaticoduodenectomy with resection of most of the pancreas, the duodenum, part of the bile duct, and distal stomach, with reconstruction and pancreaticojejunostomy. Nationally, this code captures high-complexity, resource-intensive surgical care used for malignancy, chronic pancreatitis, and other serious pancreatic and periampullary conditions. It is significant for hospital surgical departments, payers, and surgical quality programs due to substantial inpatient utilization, perioperative risk, and cost implications.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context about the procedure, typical site-of-service expectations, and an outline of common billing modifiers when present in source data. The publication also highlights benchmarking considerations and policy-relevant factors such as inpatient admission status and operative complexity that influence coverage and reimbursement. Data not available in the input is noted where applicable. This summary is intended to orient clinicians, coding professionals, and payer analysts to the clinical and billing profile of CPT code 48150 and to indicate the types of benchmarks and policy updates typically relevant to such high-acuity surgical services.
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Billing Code Overview
CPT code 48150 describes a complex abdominal surgical procedure in which the provider removes most of the pancreas (pancreatic head and body), the duodenum, part of the bile duct, and the distal portion of the stomach, followed by reconstruction that connects the remaining pancreas to the jejunum. This operation is performed to treat conditions affecting the pancreas and nearby structures that require extensive resection and gastrointestinal reconstruction.
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Service type: Major open abdominal surgical resection with reconstruction
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Typical site of service: Inpatient hospital operating room with subsequent inpatient admission for post-operative recovery and monitoring