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    v1.0.30
    OpenPayerBilling CodesExcision Procedures on the PancreasCPT cpt-48152-subtotal-pancreatectomy-duodenectomy-with-reconstruction-no-pancreaticojejunostomy
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    CPT 48152: Pancreaticoduodenectomy (Whipple) without Pancreaticojejunostomy

    Medicare pays $2687 on average nationally for this procedure.

    CPT code 48152 describes a pancreaticoduodenectomy (Whipple) in which the surgeon removes most of the pancreas, the duodenum, part of the bile duct, and the distal stomach, with reconstruction performed without creating a pancreatic-to-jejunal anastomosis; this is an operative major abdominal surgical procedure typically performed in an inpatient hospital setting by surgical specialists for treatment of pancreatic and periampullary disease.

    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 typical patient is a 60–75-year-old adult presenting with a resectable pancreatic head malignancy (for example, adenocarcinoma) or high-grade dysplasia/neoplasm of the ampulla, distal bile duct, or periampullary region. The patient commonly has progressive jaundice, weight loss, abdominal pain, and abnormal liver function tests. Preoperative workup includes contrast-enhanced CT or MRI, endoscopic ultrasound with biopsy, staging labs, and optimization of nutrition and comorbidities. The operative plan is a pancreaticoduodenectomy (Whipple) with antrectomy and reconstruction in which the majority of the pancreas, the duodenum, the distal bile duct, and part of the stomach are removed. Reconstruction is performed without creating a pancreatojejunostomy (for example, pancreatoenteric drainage not performed or external pancreatic duct drainage). Typical intraoperative teams include an attending hepatopancreatobiliary surgeon, anesthesiology, surgical assistants, and nursing; postoperative care includes intensive monitoring for hemorrhage, anastomotic leak, pancreatic fistula, delayed gastric emptying, and glycemic control. The procedure is usually performed in an inpatient hospital operating room under general anesthesia. Typical sites of service are acute care hospitals or tertiary referral centers with complex surgical services.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    43280Esophagogastroduodenoscopy, flexible, transoral; diagnostic, with or without collection of specimen(s) by brushing or washingPreoperative endoscopic evaluation and biopsy of periampullary lesions or for gastric outlet assessment.
    47562Laparoscopy, surgical, cholecystectomy; with cholangiographyCommonly performed preoperatively or intraoperatively if gallbladder disease/coexisting biliary pathology is present.
    76942Ultrtrasound guidance for needle placement (e.g., aspiration, biopsy)Used for image-guided percutaneous biopsy of a pancreatic lesion when endoscopic biopsy is not feasible.
    36415Collection of venous blood by venipunctureCommon perioperative laboratory monitoring; routine and bundled with inpatient care.
    43760Pancreatectomy, distal; with splenectomy, with or without pancreatoenterostomyAlternative pancreatic resection codes; related when additional or staged pancreatic resections are performed.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    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…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due 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…
    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…
    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
    207V00000X
    2080P0206X
    207L00000X
    2080P0006X
    207ND0101X
    126900000X
    207ZP0213X
    332BD1200X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    C25.0Malignant neoplasm of head of pancreas
    C25.1Malignant neoplasm of body of pancreas
    C25.2Malignant neoplasm of tail of pancreas
    C25.3Malignant neoplasm of pancreatic duct
    C25.4Malignant neoplasm of endocrine pancreas
    C25.7Malignant neoplasm of other parts of pancreas
    C25.8Malignant neoplasm of overlapping sites of pancreas
    C25.9Malignant neoplasm of pancreas, unspecified
    E84.9Cystic fibrosis, unspecified
    I85.01Esophageal varices with bleeding

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    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-48100-OPEN-SURGICAL-PANCREATIC-BIOPSY-PATHOLOGY-SAMPLE

    CPT 48100: Open Biopsy of Pancreatic Lesion

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

    CPT 48102: Percutaneous Needle Biopsy of Pancreas

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

    CPT 48105: Pancreatic Resection and Debridement for Necrotizing Pancreatitis

    CPT-48120-PANCREATIC-LESION-EXCISION

    CPT 48120: Excision of Lesion of Pancreas

    CPT-48140-DISTAL-PANCREATECTOMY-WITHOUT-PANCREATICOJEJUNOSTOMY

    CPT 48140: Distal Pancreatectomy with or without Splenectomy

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

    CPT 48145: Distal Pancreatectomy With or Without Splenectomy

    CPT-48146-NEAR-TOTAL-PANCREATECTOMY

    CPT 48146: Near Total Pancreatectomy

    CPT-48148-AMPULLA-OF-VATER-REMOVAL-AMPULLECTOMY

    CPT 48148: Removal of the Ampulla of Vater

    CPT-48150-PANCREATICODUODENECTOMY-PYLORUS-RESECTING

    CPT 48150: Pancreaticoduodenectomy (Whipple) with Reconstruction

    CPT-48153-PANCREATICODUODENAL-RESECTION-WITH-RECONSTRUCTION

    CPT 48153: Pylorus-Preserving Pancreaticoduodenectomy

    Showing 1–10 of 13

    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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