CPT code 48152 represents a complex major abdominal surgery — subtotal pancreatectomy with duodenectomy, partial bile duct resection, distal gastrectomy, and reconstructive procedures performed without a pancreatic-to-jejunal anastomosis. This procedure is clinically significant because it addresses extensive pancreatic and periampullary disease while avoiding a pancreaticojejunostomy, which can affect postoperative risk profiles such as pancreatic fistula. Nationally, the code is used to categorize resource-intensive inpatient surgical care with implications for hospital billing, case-mix measurement, and quality reporting.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical intent and settings for CPT code 48152, common modifiers used with major surgical claims, and the typical inpatient surgical context for payment and utilization reviews. The publication also outlines areas relevant to benchmarking and policy updates, including inpatient reimbursement considerations and clinical documentation elements tied to major abdominal resections.

This summary provides clinicians, coding professionals, and policy analysts with the context needed to interpret claims using CPT code 48152, understand where the service is typically delivered, and identify topics to review when assessing coding accuracy and hospital resource use. Data not available in the input regarding associated taxonomies, ICD-10 diagnoses, and related codes.