CPT 48552 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • 51 - Multiple procedures • 62 - Co-Surgeons |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 48552 |
National average reimbursement for CPT 48552 by major payers:
$295.22
$317.04
$324.79
$392.26
| 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 48552 | ||||||
United | 48552 | $1146.00 | 1154911592 - BCC WEST VALLEY LLC | 854264663 - (AZ) BCC WEST VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $5127.00 | 1861913220 - SJV MANAGEMENT, LLC, SOUTH JERSEY VASCULAR SURGERY CENTER | 202273476 - (NJ) SJV MANAGEMENT, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $410.00 | 1740561018 - CHILDREN 1ST GRAND PRAIRIE, LLC, CHILDREN 1ST DENTAL & SURGERY CENTER | 453126800 - (TX) FIDUCIARY WISE, LLC FBO CHILDREN 1ST DENTAL & SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $369.00 | 1730132853 - OUTPATIENT SURGERY CENTER, INC. | 204305130 - (AR) OUTPATIENT SURGERY CENTER INC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $1040.00 | 1679108914 - PRECISION SC, LLC, PRECISIONCARE SURGERY CENTER | 832882696 - (NY) PRECISION SC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $3078.00 | 1194813840 - SURGERY CENTER OF WISCONSIN RAPIDS, LLC | 203672837 - (WI) SURGERY CENTER OF WISCONSIN RAPIDS LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $743.00 | 1154326650 - SCOTTSDALE SURGICAL PARTNERS LLC, NORTH VALLEY SURGERY CENTER | 201808351 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $514.00 | 1699748855 - MIDDLETOWN ENDOSCOPY ASC LLC, THE GI ENDOSCOPY CENTER | 621835826 - (OH) MIDDLETOWN ENDOSCOPY ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $486.00 | 1689682247 - ST. PETERSBURG ENDOSCOPY CENTER LLC | 203046109 - (FL) ST. PETERSBURG ENDOSCOPY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $784.00 | 1871939082 - RAYMOND RENAISSANCE SURGERY CENTER LLC | 462035014 - (CA) RAYMOND RENAISSANCE SURGERY CE | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $298.00 | 1295851137 - PHYSICIANS SURGERY CENTER LLC | 200435814 - (AR) PHYSICIANS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $200.00 | 1710985445 - HERSHEY ENDOSCOPY CENTER, LLC | 562336622 - (PA) HERSHEY ENDOSCOPY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $825.00 | 1093705774 - SURGICENTER OF MANSFIELD, LTD. | 311515255 - (OH) SURGICENTER OF MANSFIELD, LTD. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $724.00 | 1144416587 - DIGESTIVE ENDOSCOPY CENTER LLC | 311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48552 | $541.00 | 1194720730 - UROLOGY ASSOCIATES OF CENTRAL CALIFORNIA, INC, UROLOGY ASSOCIATES OF CENTRAL CALIFORNIA AMBULATORY SURGICAL CENTER | 770488894 - (CA) UROLOGY ASSOCIATES OF CENTRAL CALIFORNIA INC | CA | 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 48552 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48552 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 48552 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 |
|---|---|---|
| 48160-CPT | High | Pancreatectomy Total W Transplant |
| 48551-CPT | Moderate | Backbench Standard Preparation Of Cadaver Donor Pancreas Allograft Prior To Transplantation Including Dissection Of Allograft From Surrounding Soft Tissues Splenectomy Duodenotomy Ligatiin Of Bile Duct Ligation Of Mesenteric Vessels And Y-Graft Arterial Anastomoses From Iliac Artery To Superior Mesenteric Artery And To Splenic Artery |
| 48552-CPT | Moderate | Backbench Reconstruction Of Cadaver Donor Pancreas Allograft Prior To Transplantation, Venous Anastomosis, Each |
| 48554-CPT | High | Transplantation Of Pancreatic Allograft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48552 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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