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 |
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 | $644.00 | 1699054098 - SURGCENTER OF WESTERN MARYLAND, LLC | 272969860 - (MD) SURGCENTER OF WESTERN MARYLAND, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $257.00 | 1376789248 - PIONEER AMBULATORY SURGERY CENTER, LLC | 262749514 - (NC) PIONEER AMBULATORY SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $471.00 | 1528253523 - MESQUITE TX ENDOSCOPY ASC LLC, TEXAS GI ENDOSCOPY CENTER | 260290859 - (TX) THE MESQUITE TX ENDOSCOPY ASC, LLC D.B.A | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $172.00 | 1558748996 - NEMG GASTROENTEROLOGY LLC, FAIRFIELD COUNTY ENDOSCOPY CENTER | 473578382 | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $384.00 | 1730570003 - SMART PAIN SURGERY CENTER AT GERMANTOWN, LLC, CLEARWAY SURGERY CENTER OF GERMANTOWN | 472908671 - (MD) SMART PAIN SURGERY CENTER AT GERMANTOWN LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $2200.00 | 1386113090 - SURGERY CENTER OF MT. SCOTT, LLC | 832600045 | OR | 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 | $390.00 | 1396266441 - EYE SURGERY CENTER OF EAST TEXAS LLC | 811881035 - (TX) EYE SURGERY CENTER OF EAST TEXAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $598.00 | 1073516795 - SPRING PARK SURGERY CENTER L L C | 421483989 - (IA) SPRING PARK SURGERY CENTER, LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $2172.00 | 1992721591 - DAY SURGERY CENTER OF NORTH TEXAS LTD | 260308454 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $1146.00 | 1275158495 - BCC CHANDLER LLC | 851284830 - (AZ) BCC CHANDLER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $424.00 | 1447258603 - SNOWDEN RIVER SURGERY CENTER LLC | 200946902 - (MD) SNOWDEN RIVER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $519.00 | 1063584415 - CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA, CAROLINA DIGESTIVE ENDOSCOPY CENTER | 561335864 - (NC) CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $588.00 | 1891184826 - SURGICAL CENTER OF NORTH FLORIDA, LLC, SURGICAL CENTER OF NORTH FLORIDA | 463936705 - (FL) SURGICAL CENTER OF NORTH FLORIDA, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48550 | $993.00 | 1578003208 - MINNESOTA EYE LASER & SURGERY CENTERS, LLC | 460505033 - (MN) MINNESOTA EYE LASER SURGERY CENTERS LLC | MN | 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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