CPT 48152 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 21 - Inpatient Hospital • 99 - Other POS |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 48152 |
National average reimbursement for CPT 48152 by major payers:
$3,524.37
$3,848.26
$4,014.08
$4,674.09
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 48152 | ||||||
United | 48152 | $1420.00 | 1780964866 - BAPTIST PLAZA SURGICARE, LP, NASHVILLE ENDOSURGERY CENTER | 800033564 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $318.00 | 1093993727 - CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER | 261708694 - (NC) CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $1056.00 | 1245436823 - EASTERN MASSACHUSETTS SURGERY CENTER LLC, EASTERN MASSACHUSETTS SURGERY CENTER | 260393450 - (MA) EASTERN MASSACHUSETTS SURGERY CENTER | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $1134.00 | 1053409896 - MID COUNTY SURGERY CENTER | 200465444 - (MO) MID COUNTY SURGERY CENTER | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $6343.00 | 1285872945 - MONTEREY PENINSULA SURGERY CENTER MUNRAS AVE | 770470910 - (CA) MONTEREY PENINSULA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $1175.00 | 1902877509 - CULPEPER SURGERY CENTER LLC | 541975624 - (VA) CULPEPER SURGERY CENTER, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $384.00 | 1720752629 - BAY SURGERY CENTERS | 453365193 - (MD) BAY SURGERY CENTERS | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $494.00 | 1942808571 - SIGHT PARTNERS PHYSICIANS, P.C., THE HARMAN EYE CLINIC | 911719913 - SIGHT PARTNERS, LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $564.00 | 1588323513 - RIVER POINT SURGERY CENTER, LLC | 863521069 - RIVER POINT SURGERY CENTER | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $2044.00 | 1811973639 - SUMMIT ORTHOPEDICS LTD, DBA LANDMARK SURGERY CENTER | 411762331 - SUMMIT ORTHOPEDICS, LTD. | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $534.00 | 1487609335 - THE CENTER FOR AESTHETIC SURGERY LLC | 200431536 - (MD) THE CENTER FOR AESTHETIC SURGERY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $750.00 | 1346220183 - BLACK HILLS REGIONAL EYE SURGERY CENTER, LLC | 460462601 - (SD) BLACK HILLS REGIONAL EYE SURGERY CENTER LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $424.00 | 1346215316 - CHESAPEAKE EYE SURGERY CENTER, LLC | 522310068 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $600.00 | 1912412420 - GALEA CENTER, LLC., GALEA CENTER FOR ADVANCED SURGERY | 821939476 - (CA) GALEA CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48152 | $1000.00 | 1528219474 - CLARKSTON ASC PARTNERS LLC, CLARKSTON SURGERY CENTER | 203360827 - (MI) CLARKSTON ASC PARTNERS, LLC DBA CLARKSTON SURGERY CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 48152 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48152 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 48152 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 |
|---|---|---|
| 48150-CPT | High | Pancreatectomy, Proximal Subtotal With Total Duodenectomy, Partial Gastrectomy, Choledochoenterostomy And Gastrojejunostomy (Whipple-Type Procedure); With Pancreatojejunostomy |
| 48152-CPT | High | Pancreatectomy, Proximal Subtotal With Total Duodenectomy, Partial Gastrectomy, Choledochoenterostomy And Gastrojejunostomy (Whipple-Type Procedure); Without Pancreatojejunostomy |
| 48153-CPT | High | Pancreatectomy Proximal Subtotal With Near-Total Duodenectomy Choledochoenterostomy And Duodenojejunostomy (Pylorus-Sparing Whipple-Type Procedure); With Pancreatojejunostomy |
| 48154-CPT | High | Pancreatectomy Proximal Subtotal With Near-Total Duodenectomy Choledochoenterostomy And Duodenojejunostomy (Pylorus-Sparing Whipple-Type Procedure); Without Pancreatojejunostomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48152. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48152 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 48152) and we'll show you how you compare in 15 minutes or less.