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    v1.0.30
    OpenPayerBilling CodesPancreas Transplantation ProceduresCPT cpt-48556-donor-pancreas-explantation
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    CPT 48556: Explantation of Transplanted Pancreas

    Medicare pays $1260 on average nationally for this procedure.

    CPT code 48556 describes surgical explantation of a previously transplanted donor pancreas when the transplant has failed to function; the service is a surgical removal procedure (pancreas explant) typically performed in an inpatient operating room or surgical suite under general anesthesia as part of transplant failure management.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 52-year-old patient with a history of simultaneous pancreas-kidney transplantation presents months after transplant with progressive graft dysfunction characterized by persistent hyperglycemia, recurrent infections localized to the graft site, and imaging evidence of graft necrosis and fistula formation. The patient is admitted to a tertiary care transplant center. The transplant surgery team evaluates the patient, obtains preoperative labs (CBC, CMP, coagulation studies), crossmatch and infectious workup, and imaging (CT abdomen/pelvis with contrast). After multidisciplinary review including transplant nephrology and infectious disease, the decision is made to remove the failing donor pancreas (explant) due to irreversible graft failure, sepsis risk, or refractory graft pancreatitis.

    The clinical workflow includes preoperative optimization (antibiotics if infected, adjustment of immunosuppression), informed consent specifying risks of explantation and potential impact on diabetes management, scheduling in the operating room with general anesthesia, intraoperative explant of the donor pancreas (often via laparotomy), hemostasis and possible drainage placement, and postoperative monitoring in a recovery or surgical ward with attention to fluid status, glycemic control, wound care, and immunosuppression adjustments. Documentation must identify the removed organ as a previously transplanted donor pancreas. Billing and coding use 48556 for removal of a previously transplanted donor pancreas when performed because of graft failure or complications.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99223Initial hospital care, typically 70 minutes or morePreoperative evaluation and management of a complex transplant patient prior to explantation.
    48556Removal of previously transplanted donor pancreasPrimary procedure code describing explantation of a failed donor pancreas.
    38240Allogeneic hematopoietic stem cell transplantation; not applicableData not available in the input.
    36415Collection of venous blood by venipuncturePreoperative lab draw for testing and crossmatch.
    54150Repair of scrotum/testis (example unrelated)Data not available in the input.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    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…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207LA0401X
    261QA0006X
    2080H0002X
    2278P1006X
    207XX0005X
    1223D0004X
    213ES0131X
    1744R1103X

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-48550-PANCREAS-PROCUREMENT-DONOR-ORGAN-RECOVERY

    CPT 48550: Pancreas Retrieval from Deceased Donor

    CPT-48551-PANCREAS-DONOR-PREPARATION-FOR-TRANSPLANTATION

    CPT 48551: Pancreas Preparation from Deceased Donor for Transplant

    CPT-48552-DONOR-PANCREAS-VEIN-RECONSTRUCTION-ORGAN-PREPARATION

    CPT 48552: Pancreas Vein Reconstruction for Donor Organ Preparation

    CPT-48554-PANCREAS-ALLOGRAFT-IMPLANTATION-EXTRACORPOREAL-DONOR

    CPT 48554: Cadaveric Pancreas Implantation, Native Pancreas Retained

    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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