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See a sample rate comparisonCPT 48547 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.
Duodenal Exclusion W/ Gastrojejunostomy For Pancreatic Njury, Duodenal Exclusion With Gastrojejunostomy For Pancreatic Injury
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 78 - Return to OR - related procedure 80 - Assistant surgeon 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 48547 |
| Medicaid Fee Schedule | View Medicaid rates for 48547 |
National average reimbursement for CPT 48547 by major payers:
$2,268.16
$2,373.24
$2,463.77
$2,829.07
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CPT 48547
5 of 25 sample ratesHigher to lower in this preview
Hunt Memorial Hospital District, Hunt Regional Healthcare
Hunt Memorial Hospital District
$5,600.00Published rateLafayette Surgery Center Limited Partnership
$1,640.00Published rateSurgcenter Of Fayetteville, LLC
Surgcenter Of Fayetteville LLC
$668.00Published rateSummit Ambulatory Surgical Center, LLC
$430.00Published rateCastleman Surgery Center, LLC, Southgate Surgery Center
Castleman Surgery Center LLC
$97.00Published rate
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See a sample payer proposalCPT 48547 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48547 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 48547 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 |
|---|---|---|
| 48148-CPT | High | Remove Part Of Bile Duct, Surgery To Remove The Ampulla Of Vater A Portion Of The Bile Duct Where The Ducts From The Liver And The Pancreas Meet. |
| 48154-CPT | High | Pancreatic Surgery, Pancreatectomy Proximal Subtotal With Near-Total Duodenectomy Choledochoenterostomy And Duodenojejunostomy (Pylorus-Sparing Whipple-Type Procedure); Without Pancreatojejunostomy |
| 48545-CPT | High | Pancreatorraphy For Trauma |
| 48547-CPT | High | Duodenal Exclusion W/ Gastrojejunostomy For Pancreatic Njury, Duodenal Exclusion With Gastrojejunostomy For Pancreatic Injury |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48547. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48547 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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