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See a sample rate comparisonCPT 48120 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Excision Lesion Pancreas-Cyst, Adenoma
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 48120 |
| Medicaid Fee Schedule | View Medicaid rates for 48120 |
National average reimbursement for CPT 48120 by major payers:
$1,374.93
$1,467.55
$1,547.17
$1,760.77
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CPT 48120
5 of 25 sample ratesHigher to lower in this preview
Park Hill Surgery Center, LLC
Park Hill Surgery Center LLC
$6,068.00Published rateOak Tree Surgery Center, LLC
Oak Tree Surgery Center, Ll, LLC
$1,306.00Published rateColiseum Same Day Surgery Center Lp
$969.00Published rateSt. Petersburg Endoscopy Center LLC
St. Petersburg Endoscopy Center, LLC
$486.00Published rateBrazosport Eye Facility, Inc., Brazosport Eye Institute
Brazosport Eye Facility Inc
$191.00Published rate
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See a sample payer proposalCPT 48120 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48120 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 48120 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 48000-CPT | High | Pancreas Surgery For Drainage, Surgery On The Pancreas To Place Drains To Help With Inflammation (Pancreatitis). The Procedure Can Involve The Bile Ducts Stomach And Small Intestine. |
| 48020-CPT | High | Remove Pancreatic Calculus |
| 48105-CPT | High | Resct Or Debrideme Of Pancreas & Peripancreatic Tissue For Acu, Resection Or Debridement Of Pancreas And Peripancreatic Tissue For Acu |
| 48120-CPT | High | Excision Lesion Pancreas-Cyst, Adenoma |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48120. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48120 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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