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 48520 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.
Intern Anastomsis Of Pancreatic Cyst To Gastrointes Tract; Dir, Internal Anastomosis Of Pancreatic Cyst To Gastrointestinal Tract; Dir
| 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 51 - Multiple procedures 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 48520 |
| Medicaid Fee Schedule | View Medicaid rates for 48520 |
National average reimbursement for CPT 48520 by major payers:
$1,359.45
$1,450.20
$1,520.05
$1,742.00
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 48520.
CPT 48520
5 of 25 sample ratesHigher to lower in this preview
Foundation Surgery Affiliate Of Huntingdon Valley Lp, Huntingdon Valley Surgery Center
Foundation Surgery Affiliate Of Huntingdon Valley
$4,300.00Published rateOrthopedic Surgery Center Of Oc LLC
$1,687.00Published rateNorthern Ec LLC
$951.00Published rateNaples Suncoast Surgery Center, LLC
Naples Suncoast Surgery Center LLC
$461.00Published rateLisa Renfro Surgery Center LLC
$200.00Published 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 48520 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48520 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 48520 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 |
|---|---|---|
| 48102-CPT | Moderate | 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. |
| 48105-CPT | High | Resct Or Debrideme Of Pancreas & Peripancreatic Tissue For Acu, Resection Or Debridement Of Pancreas And Peripancreatic Tissue For Acu |
| 48500-CPT | High | Marsupialize Cyst Pancreas |
| 48520-CPT | High | Intern Anastomsis Of Pancreatic Cyst To Gastrointes Tract; Dir, Internal Anastomosis Of Pancreatic Cyst To Gastrointestinal Tract; Dir |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48520 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 48520) and we'll show you how you compare in 15 minutes or less.