Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 48153 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.
Pancreatic Surgery, Pancreatectomy Proximal Subtotal With Near-Total Duodenectomy Choledochoenterostomy And Duodenojejunostomy (Pylorus-Sparing Whipple-Type Procedure); With Pancreatojejunostomy
| 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 |
| Medicaid Fee Schedule | View Medicaid rates for 48153 |
National average reimbursement for CPT 48153 by major payers:
$3,895.65
$4,137.27
$4,448.92
$4,918.52
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 48153.
CPT 48153
5 of 25 sample ratesHigher to lower in this preview
Lowcountry Surgery Center LLC, Roper St Francis Eye Center
Lowcountry Surgery Center
$7,840.00Published rateNaugatuck Valley Endoscopy Center, LLC, Waterbury Surgery Center
Naugatuck Valley Endoscopy Cente
$1,339.00Published rateEndoscopy Center Of The South Bay Lp, Endoscopy Center Of The South Bay
$722.00Published rateSurgery Center Of Anaheim Hills, LLC
Surgery Center Of Anaheim Hills LLC
$450.00Published rateRegional Eye Surgery Center,LLC
Regional Eye Surgery Center, LLC
$210.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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 | Anastomsis Of Extrahepatic Biliary Ducts & Gastrointes Tract, Anastomosis Of Extrahepatic Biliary Ducts And Gastrointestinal Tract |
| 47785-CPT | High | Anastomsis Roux-En-Y Of Intrahepatic Biliary Ducts & Gastrointe, Anastomosis Roux-En-Y Of Intrahepatic Biliary Ducts And Gastrointest |
| 48150-CPT | High | Partial Removal Of Pancreas, Pancreatectomy Proximal Subtotal With Total Duodenectomy Partial Gastrectomy Choledochoenterostomy And Gastrojejunostomy Whipple Type Procedure With Pancreatojejunostomy |
| 48153-CPT | High | Pancreatic Surgery, 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 48153) and we'll show you how you compare in 15 minutes or less.