CPT 48155 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 22 - Increased Procedural Services |
| Complexity Level | High |
| CMS | $1,771.62 Physician Fee Schedule |
National average reimbursement for CPT 48155 by major payers:
$2,428.55
$2,400.71
$2,544.66
$2,949.22
| 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 48155 | ||||||
United | 48155 | $250.00 | 1710552278 - CHILDREN'S DENTAL SURGERY CENTER OF JACKSON LLC, CHILDREN'S DENTAL SURGERY OF JACKSON | 852790585 - (NJ) CHILDRENS DENTAL SURGERY CENTER OF JACKSON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $567.00 | 1699751289 - EASTLAND MEDICAL PLAZA SURGICENTER, LLC | 371400643 - (IL) EASTLAND MEDICAL PLAZA SURGICENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $592.00 | 1225039761 - ENDOSCOPY CENTER OF ST THOMAS LLC, ST THOMAS MEDICAL GROUP ENDOSCOPY CENTER | 621512411 - (TN) ENDOSCOPY CENTER OF ST THOMAS LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $862.00 | 1073763652 - LEBONHEUR EAST SURGERY CENTER II LP, LEBONHEUR EAST SURGERY CENTER LP | 800247391 - (TN) LEBONHEUR EAST SURGERY CENTER II LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $546.00 | 1558859645 - EAST FREEDOM SURGICAL ASSOCIATES, LLC | 820930718 - (PA) EAST FREEDOM SURGICAL ASSOCIATES LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $512.00 | 1750364634 - BETHESDA OUTPATIENT SURGERY CENTER LLC, PALM BEACH OUTPATIENT SURGERY CENTER | 651028884 - (FL) BETHESDA OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $1101.00 | 1164582649 - STRICTLY PEDIATRICS SURGERY CENTER OF CENTRAL TEXAS, LLC, STRICTLY PEDIATRICS SURGERY CENTER | 200943974 - (TX) STRICTLY PEDIATRICS SURGERY CENTER OF TEXAS, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $1029.00 | 1497465249 - CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION, CONFLUENCE HEALTH MOSES LAKE ASC | 910171250 - CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $994.26 | 1679694004 - GI SPECIALISTS LLC, MORELAND ENDOSCOPY CENTER | 205269133 - (WI) GI SPECIALISTS LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $700.00 | 1093156937 - QUALITY CARE SURGERY CENTER, LLC | 462355538 - (CA) QUALITY CARE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $1954.00 | 1053971457 - BAPTIST HEALTH SURGERY CENTER LLC, BAPTIST HEALTH SURGERY CENTER AT BETHESDA WEST | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $350.00 | 1992423719 - ENDOSCOPY ASC OF MIDDLE GEORGIA LLC | 883065469 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $500.00 | 1639431653 - DESERT CLIFFS SURGERY CENTER LLC | 800824134 - (AZ) DESERT CLIFFS SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $1049.00 | 1386086411 - MARION SURGERY CENTER, LLC | 462447139 - (FL) MARION SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48155 | $1080.00 | 1063595221 - SURGERY CENTER OF LOVELAND, LLC, LOVELAND SURGERY CENTER | 900985087 - (CO) SURGERY CENTER OF LOVELAND LLC | CO | 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 48155 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48155 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 48155 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 |
|---|---|---|
| 48155-CPT | High | Pancreatectomy Total; |
| 48160-CPT | High | Pancreatectomy Total W Transplant |
| 48550-CPT | High | Donor Pancreatectomy With Preparation And Maintenance Of Allograft From Cadaver Donor With Or Without Duodenal Segment For Transplantation |
| 48554-CPT | High | Transplantation Of Pancreatic Allograft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48155. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48155 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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