2025 CPT code 48152
Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without pancreatojejunostomy.
Modifiers may be applicable to indicate specific circumstances of the procedure (e.g., increased procedural services, assistant surgeon). Refer to current year's modifier guidelines for appropriate usage.
Medical necessity must be established by demonstrating the clinical indication for the procedure, such as a cancerous or benign tumor, chronic pancreatitis, or other conditions affecting the head of the pancreas and surrounding structures.
The surgeon is responsible for performing the procedure, which involves detailed knowledge of the anatomy, safe dissection techniques, meticulous reconstruction of the digestive tract, and management of potential complications.
In simple words: This surgery removes the head of the pancreas, the first part of the small intestine (duodenum), part of the stomach, and a section of the bile duct. The surgeon then reconnects the remaining parts of the stomach and bile duct to the small intestine to restore digestive function. Importantly, the remaining pancreas is not reconnected to the digestive system in this specific procedure.
This procedure involves the removal of the head of the pancreas, the entire duodenum, a portion of the stomach, and part of the bile duct. The remaining stomach is then connected to the jejunum, and the common bile duct is also connected to the jejunum. A pancreatojejunostomy, which connects the pancreas to the jejunum, is not performed in this procedure.
Example 1: A patient with a cancerous tumor in the head of the pancreas undergoes a Whipple procedure without pancreatojejunostomy (48152)., A patient with chronic pancreatitis affecting the head of the pancreas undergoes a Whipple procedure (48152) to alleviate pain and improve digestive function., A patient with a benign tumor in the head of the pancreas that is causing obstructive jaundice and pain undergoes a Whipple procedure (48152).
Operative report detailing the extent of resection, reconstruction performed, intraoperative findings, and any complications. Pathology report confirming the diagnosis.
- RVU: Refer to the current year's Medicare Physician Fee Schedule for specific RVU values.
- Global Days: Global days are assigned based on the complexity of the procedure and postoperative care required. Refer to current year's Medicare guidelines for specific global days associated with this code.
- Specialties:Surgical Oncology, General Surgery, Hepatopancreatobiliary Surgery
- Place of Service:Inpatient Hospital