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See a sample rate comparisonCPT 48500 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.
Marsupialize Cyst Pancreas
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 62 - Co-Surgeons AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 48500 |
| Medicaid Fee Schedule | View Medicaid rates for 48500 |
National average reimbursement for CPT 48500 by major payers:
$1,428.58
$1,512.72
$1,573.66
$1,819.25
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CPT 48500
5 of 25 sample ratesHigher to lower in this preview
Doctors Outpatient Center For Surgery, LLC
Doctors Outpatient Center For Surgery LLC
$1,322.00Published rateFish Pond Surgery Center, LLC
Fish Pond Surgery Center LLC
$1,049.00Published rateDeschutes Surgery Center, LLC, Deschutes Surgery Center, LLC
Deschutes Surgery Center LLC
$750.00Published rateSouth Sound Surgery, PLLC, Auburn Surgical Center
South Sound Surgery PLLC
$650.00Published rateTranssouth Health Care PLLC, Transsouth Health Care PC
Transsouth Health Care, P.C.
$300.00Published rate
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See a sample payer proposalCPT 48500 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48500 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 48500 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. |
| 48100-CPT | High | Pancreas Biopsy, A Procedure To Remove A Sample Of Tissue From The Pancreas For Testing (Biopsy). The Sample May Be Taken In A Surgery Or With A Needle. |
| 48120-CPT | High | Excision Lesion Pancreas-Cyst, Adenoma |
| 48500-CPT | High | Marsupialize Cyst Pancreas |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48500. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48500 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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