CPT 48153 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 22 - Increased Procedural Services • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 48153 |
National average reimbursement for CPT 48153 by major payers:
$3,895.65
$4,137.27
$4,448.92
$5,030.20
| 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 48153 | ||||||
United | 48153 | $7840.00 | 1740562677 - LOWCOUNTRY SURGERY CENTER LLC, ROPER ST FRANCIS EYE CENTER | 581693021 - (SC) LOWCOUNTRY SURGERY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $228.00 | 1013222926 - CARLIN VISION SURGERY CENTER LLC | 272799561 - (GA) CARLIN VISION SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $6068.00 | 1720603079 - TEXAS HEALTH SURGERY CENTER CHISHOLM TRAIL, LLC | 851225852 - (TX) TEXAS HEALTH SURGERY CENTER CHISHOLM TRAIL LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $3493.00 | 1447212121 - CHRISTUS SANTA ROSA OUTPATIENT SURGERY, CHRISTUS PHYSICIANS SURGERY CENTER - NEW BRAUNFELS | 810571409 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $2285.00 | 1083715148 - ASC SURGICAL VENTURES, LLC, OSMC OUTPATIENT SURGERY CENTER | 351995261 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $994.26 | 1851887715 - SOUTHERN LAKES ENDOSCOPY LLC | 824245460 - (WI) SOUTHERN LAKES ENDOSCOPY LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $450.00 | 1053852236 - SURGERY CENTER OF ANAHEIM HILLS, LLC | 814260687 - (CA) SURGERY CENTER OF ANAHEIM HILLS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $983.00 | 1134126097 - PHYSICIAN'S SURGERY CENTER OF KNOXVILLE LLC | 621777892 - (TN) PHYSICIANS SURGERY CENTER OF KNOXVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $210.00 | 1477698454 - REGIONAL EYE SURGERY CENTER,LLC | 721484653 - (LA) REGIONAL EYE SURGERY CENTER, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $375.00 | 1922211192 - VOORHEES SURGERY CENTER, LLC | 651203770 - (NJ) VOORHEES SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $450.00 | 1831496231 - ANTELOPE VALLEY SURGERY CENTER, PC | 263584379 - (CA) ANTELOPE VALLEY SURGERY CENTER PC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $615.00 | 1518998764 - TENNESSEE PAIN SURGERY CENTER, LLC | 621790133 - (TN) TENNESSEE PAIN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $1028.00 | 1184714214 - GAINESVILLE ENDOSCOPY CENTER, LLC | 10750801 - (GA) GAINESVILLE ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $750.00 | 1043564784 - COMPREHENSIVE SURGICAL CENTER OF GREEN, LLC | 461313857 - (OH) COMPREHENSIVE SURGICAL CENTER OF GREEN LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48153 | $670.00 | 1013471754 - ADVANCED SURGERY CENTER OF LANCASTER, LLC | 831133719 - (PA) ADVANCED SURGERY CENTER OF LANCASTER LLC | PA | 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 |
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CPT 48153 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48153 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 48153 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 |
|---|---|---|
| 47760-CPT | High | Anastomosis Exthepat Ducts+Gi Tract |
| 47785-CPT | High | Anastomosis, Roux-En-Y, Of Ntraheptic Biliary Ducts & Gstrontstnl Trct |
| 48150-CPT | High | Pancreatectomy, Proximal Subtotal With Total Duodenectomy, Partial Gastrectomy, Choledochoenterostomy And Gastrojejunostomy (Whipple-Type Procedure); With Pancreatojejunostomy |
| 48153-CPT | High | Pancreatectomy Proximal Subtotal With Near-Total Duodenectomy Choledochoenterostomy And Duodenojejunostomy (Pylorus-Sparing Whipple-Type Procedure); With Pancreatojejunostomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48153. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48153 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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