2025 CPT code 48150
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy, and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy.
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22), multiple procedures (51), or the presence of an assistant surgeon (80). Refer to current CPT guidelines for appropriate modifier usage.
Medical necessity for 48150 is established by appropriate documentation of a condition requiring the removal of parts of the pancreas, duodenum, stomach, and bile duct, such as cancer, precancerous lesions, or severe chronic pancreatitis.Documentation should demonstrate failed conservative management and the clinical rationale for this extensive surgical intervention.
The surgeon performs the exploration, excision, and reconstruction of the affected organs.
In simple words: This is a complex surgery where a portion of the pancreas, small intestine, stomach, and bile duct are removed, typically due to cancer. The remaining parts are then reconnected to allow for normal digestion.
This procedure involves the removal of the head of the pancreas (proximal subtotal pancreatectomy) along with the entire duodenum (total duodenectomy), a portion of the stomach (partial gastrectomy), and part of the bile duct.The surgery also includes the reconstruction of the digestive tract by connecting the remaining pancreas to the jejunum (pancreatojejunostomy), the common bile duct to the intestine (choledochoenterostomy), and the stomach to the jejunum (gastrojejunostomy).
Example 1: A patient with pancreatic head cancer undergoes a Whipple procedure (48150) to remove the tumor and restore digestive function. The procedure includes a pancreatojejunostomy, choledochoenterostomy, and gastrojejunostomy., A patient with a precancerous lesion in the head of the pancreas undergoes a Whipple procedure (48150) as a preventative measure. The procedure includes resection of the affected portion of the pancreas, duodenum, stomach, and bile duct, followed by reconstruction., A patient with chronic pancreatitis causing severe pain and digestive issues undergoes a Whipple procedure (48150). The surgery aims to alleviate symptoms by removing the diseased portion of the pancreas and reconstructing the digestive tract.
Operative report detailing the extent of resection, reconstruction performed, and any complications encountered. Pathology report confirming the diagnosis. Preoperative imaging and diagnostic studies supporting the medical necessity of the procedure.
** The inclusion of "with pancreatojejunostomy" in the code description indicates that the remaining pancreas is connected to the jejunum. If this connection is not performed, use code 48152.
- Revenue Code: P1G (Berenson-Eggers Type of Service: MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Specialties:General surgery, Hepatopancreatobiliary surgery, Surgical oncology
- Place of Service:Inpatient Hospital