CPT 48550 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 |
| Common Modifiers | • None |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 48550 |
National average reimbursement for CPT 48550 by major payers:
$1,331.31
$2,208.80
$2,100.81
$3,341.61
| 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 48550 | ||||||
United | 48550 | $624.00 | 1245471788 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $480.00 | 1699959387 - SAN DIEGO CA MULTI SPECIALTY ASC LLC, MISSION VALLEY HEIGHTS SURGERY CENTER | 261158246 - (CA) POWAY CA MULTI-SPECIALTY ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $1344.00 | 1205875283 - RWJ ENDOSURGICAL CENTER LLC | 900872940 - (NJ) RWJ ENDOSURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $707.00 | 1831545904 - MGH SURGERY LLC | 472736896 - (WV) MGH SURGERY LLC | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $2119.00 | 1508197039 - FREEMAN SURGICAL CENTER LLC | 431704371 - FREEMAN HEALTH SYSTEM | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $695.00 | 1922011501 - LOWERY A. WOODALL OUTPATIENT SURGERY FACILITY, LLC | 640897321 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $531.00 | 1013914985 - ROANOKE AMBULATORY SURGERY CENTER, LLC, ROANOKE AMBULATORY SURGERY CENTER | 10691564 - (VA) ROANOKE AMBULATORY SURGERY | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $4300.00 | 1669446852 - VOORHEES NJ ENDOSCOPY ASC LLC, THE ENDO CENTER AT VOORHEES | 510446274 - (NJ) THE VOORHEES NJ ENDOSCOPY ASC LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $569.00 | 1669427043 - VANCOUVER EYE CARE PS | 910913651 - (WA) VANCOUVER EYE CARE, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $743.00 | 1669426839 - NORTH VALLEY SURGEERY CENTER | 201808351 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $6068.00 | 1538104724 - FORT WORTH ENDOSCOPY CENTERS, LLC, SOUTHWEST FORT WORTH ENDOSCOPY CENTER | 770368346 - (TX) FORT WORTH ENDOSCOPY CENTERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $410.00 | 1144326307 - OLD MOULTRIE SURGICAL CENTER INC | 593572609 - (FL) OLD MOULTRIE SURGICAL CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $969.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $434.00 | 1114929957 - OPHTHALMIC OUTPATIENT SURGERY CENTER PARTNERS, LLC, OUTPATIENT SURGERY CENTER FOR SIGHT | 721405960 - (LA) OPHTHALMIC OUTPATIENT SURGERY CENTER PARTNERS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $352.00 | 1497117113 - FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER, LLC | 352551684 - (PA) FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER LLC | PA | 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 48550 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48550 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 48550 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 |
| 48400-CPT | Low | Injection Procedure For Intraoperative Pancreatography |
| 48550-CPT | High | Donor Pancreatectomy With Preparation And Maintenance Of Allograft From Cadaver Donor With Or Without Duodenal Segment For Transplantation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48550. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48550 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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