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2025 CPT code 48154

This procedure involves removing a portion of the pancreas and almost the entire duodenum, then reconnecting the bile duct to the intestines and the duodenum to the jejunum to restore digestive function.

Follow CPT guidelines for surgical procedures on the digestive system.Appropriate modifiers should be used to reflect the complexity and extent of the procedure performed.

Modifiers 22, 51, 52, 58, 78, 79, and others may be applicable depending on the specific circumstances of the procedure.

Medical necessity is established by the presence of a surgically resectable lesion in the pancreas or duodenum that threatens function or health and cannot be treated effectively through other, less invasive means.

The surgeon is responsible for all aspects of the procedure, including patient preparation, anesthesia, incision, dissection, tissue removal, anastomosis, hemostasis, and wound closure.

IMPORTANT:If a Whipple procedure with partial stomach removal is performed, use codes 48150 and 48152. For a pylorus-sparing Whipple with pancreatojejunostomy, use code 48153.

In simple words: The surgeon removes part of the pancreas and most of the duodenum (part of the small intestine).The bile duct and remaining duodenum are then reattached to the jejunum (another part of the small intestine) to help with digestion.

Pancreatectomy, proximal subtotal with near total duodenectomy, choledochoenterostomy, and duodenojejunostomy, pylorus-preserving Whipple procedure; without pancreatojejunostomy.The procedure begins with an upper midline abdominal incision, followed by dissection to the pancreas.The proximal pancreas is freed, and diseased tissue is removed.Most of the duodenum is resected. The gallbladder may also be removed.A choledochojejunostomy (connection of the bile duct to the jejunum) and a duodenojejunostomy (connection of the remaining duodenum to the jejunum) are performed. Hemostasis is ensured, and the abdominal wound is closed. This does not include connection of the jejunum to a pancreatic duct, cyst, or fistula.

Example 1: A patient presents with a pancreatic tumor in the head of the pancreas. A pylorus-preserving Whipple procedure (48154) is performed to resect the tumor and restore digestive continuity., A patient with chronic pancreatitis undergoes a near-total duodenectomy and subtotal pancreatectomy (48154) to alleviate symptoms and improve pancreatic function., A patient with ampullary cancer undergoes a pylorus-preserving Whipple procedure (48154) involving resection of the tumor, duodenum, and part of the pancreas.Reconstruction of the biliary and pancreatic ducts is performed, and the remaining duodenum is anastomosed to the jejunum.

Preoperative imaging (CT, MRI), operative report detailing resection margins, pathology report confirming diagnosis and completeness of resection, postoperative imaging (if indicated), and progress notes documenting recovery and complications.

** This code describes a pylorus-preserving Whipple procedure without pancreatojejunostomy.The absence of pancreatojejunostomy differentiates it from code 48153.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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