`48552` Prep donor pancreas/venous

What 48552 is

CMS fee schedule short descriptor: Prep donor pancreas/venous.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 48552 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	4.19	1.02	1.12	6.33	$211.43
Facility (hospital, ASC)	4.19	1.02	1.12	6.33	$211.43

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.

Adjust for a Medicare locality:

Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

Medically Unlikely Edit (MUE)

Medicare caps 48552 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 48552? These codes are bundled into it

48552 is a Column 1 code in 29 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 code	Short description	Modifier indicator
`35531`	Art byp grft aorcel/aormesen	1 - modifier may bypass	Check pair
`35563`	Art byp grft ilioiliac	1 - modifier may bypass	Check pair
`35685`	Bypass graft patency/patch	1 - modifier may bypass	Check pair
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	0 - no modifier bypass	Check pair
`38100`	Removal of spleen total	0 - no modifier bypass	Check pair
`38101`	Removal of spleen partial	0 - no modifier bypass	Check pair
`38102`	Removal of spleen total	0 - no modifier bypass	Check pair
`44010`	Incision of small bowel	1 - modifier may bypass	Check pair
`44820`	Excision of mesentery lesion	1 - modifier may bypass	Check pair
`44850`	Repair of mesentery	1 - modifier may bypass	Check pair
`47460`	Incise bile duct sphincter	1 - modifier may bypass	Check pair
`47531`	Injection for cholangiogram	1 - modifier may bypass	Check pair
`47533`	Plmt biliary drainage cath	1 - modifier may bypass	Check pair
`47534`	Plmt biliary drainage cath	1 - modifier may bypass	Check pair
`47535`	Conversion ext bil drg cath	1 - modifier may bypass	Check pair
`47536`	Exchange biliary drg cath	1 - modifier may bypass	Check pair
`47550`	Bile duct endoscopy add-on	1 - modifier may bypass	Check pair
`47552`	Biliary endo perq dx w/speci	1 - modifier may bypass	Check pair
`47553`	Biliary endoscopy thru skin	1 - modifier may bypass	Check pair
`47554`	Biliary endoscopy thru skin	1 - modifier may bypass	Check pair
`47555`	Biliary endoscopy thru skin	1 - modifier may bypass	Check pair
`47556`	Biliary endoscopy thru skin	1 - modifier may bypass	Check pair
`48100`	Biopsy of pancreas open	1 - modifier may bypass	Check pair
`48102`	Needle biopsy pancreas	1 - modifier may bypass	Check pair
`48120`	Removal of pancreas lesion	1 - modifier may bypass	Check pair
`48545`	Pancreatorrhaphy	1 - modifier may bypass	Check pair
`69990`	Microsurgery add-on	0 - no modifier bypass	Check pair
`96523`	Irrig drug delivery device	0 - no modifier bypass	Check pair

48552 is bundled into these codes

48552 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 48552 is the code that denies.

Column 1 code	Short description	Modifier indicator
`48105`	Resect/debride pancreas	0	Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.