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See a sample rate comparisonCPT 48999 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.
Unlisted Procedure Pancreas
| 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 AS - PA/NP/CNS assistant at surgery GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 48999 |
| Medicaid Fee Schedule | View Medicaid rates for 48999 |
National average reimbursement for CPT 48999 by major payers:
$1,154.58
$245.46
$1,279.50
$1,601.89
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CPT 48999
5 of 25 sample ratesHigher to lower in this preview
Spicewood Surgery Center LLC, Spicewood Surgery Center
Spicewood Surgery Center LLC
$1,158.00Published rateSouthwest Lincoln Surgery Center, LLC, Southwest Lincoln Surgery Center
Southwest Lincoln Surgery Center LLC
$916.00Published rateCentennial Surgery Center Lp
$636.00Published rateCarolina Interventional Pain Institute, LLC, Carolina Interventional Pain Institute, LLC
Carolina Interventional Pain Institute LLC
$362.00Published rateCasc Aquisition Inc, Carolina Ambulatory Surgery Center
Casc Aquisition Inc
$172.00Published rate
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See a sample payer proposalCPT 48999 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48999 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 48999 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; |
| 48551-CPT | Moderate | Prep Donor Pancreas, Backbench Standard Preparation Of Cadaver Donor Pancreas Allograft Prior To Transplantation Including Dissection Of Allograft From Surrounding Soft Tissues Splenectomy Duodenotomy Ligation 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 | Prep Donor Pancreas Venous, Backbench Reconstruction Of Cadaver Donor Pancreas Allograft Prior To Transplantation Venous Anastomosis Each |
| 48999-CPT | High | Unlisted Procedure Pancreas |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48999 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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