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Billing code 38101: SplenectomyMedicare rate & RVUs

Reports surgical removal of part of the spleen while preserving remaining viable tissue, typically for a focal splenic lesion or selected splenic injury.

CMS RVU26DEffective Oct 1, 2026109 payment localities27 Medicare services in 2024

Medicare pays $1,086.53 for 38101 nationally in a facility.

Medicare rate · 38101

Splenectomy

Swap in your local Medicare rate.

Work RVUs
19.06
Total RVUs
32.53
Global days
090

National rate · 2026

$1,086.53

Facility setting, before claim adjustments.

See every locality for 38101 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 38101 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 38101 covers

The surgeon removes a portion of the spleen and preserves the remaining viable tissue. This open operation may be performed for a focal splenic lesion or selected splenic injuries when partial removal is appropriate. It is generally reported by the surgeon performing the procedure in a hospital operating room; the laparoscopic approach is represented by a separate code. For traumatic rupture, distinguish partial removal performed as part of splenic repair from a separately performed partial splenectomy.

Select this code when the operative report supports partial rather than complete removal and documents the reason for preserving splenic tissue. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Report the procedure once; modifier 50 is inappropriate for the single spleen. An assistant at surgery may be paid, co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 38101 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

38101 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$977.86
Alaska*Unavailable$1,346.87
ArizonaUnavailable$1,053.41
ArkansasUnavailable$964.73
AtlantaUnavailable$1,127.03
AustinUnavailable$1,084.71
BakersfieldUnavailable$1,059.19
Baltimore/Surr. CntysUnavailable$1,157.39
BeaumontUnavailable$1,049.26
BrazoriaUnavailable$1,051.77

38101 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
38101 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 38101 rate is calculated

Each of 38101’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 38101

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 19.06Practice expense 8.39Malpractice 5.08

32.5300 adjusted RVUs×$33.4009 conversion factor=$1,086.53

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 38101

38101 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 38101

Splenectomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.73/0.16Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 38101

Splenectomy

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

38101 without 51 · national facility

$1,086.53

Splenectomy

38101-51 · Second procedure: 50%

$543.27

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

38101 compared with similar codes

Compare codes

38101 vs 38100 vs 38102 vs 38115 vs 38120: national Medicare rates

Swap in your local Medicare rate.

  • 38101
    Splenectomy · 19.06 wRVU
    —
  • 38100
    Splenectomy · 19.06 wRVU
    —
  • 38102
    Splenectomy · 4.67 wRVU
    —
  • 38115
    Splenic repair · 21.33 wRVU
    —
  • 38120
    Splenectomy · 16.64 wRVU
    —

How to choose

38100Splenectomy
38100 is for complete splenic removal; 38101 is for removing only part while preserving viable tissue.
38102Splenectomy
38102 describes total splenectomy performed with another procedure. Use 38101 when removal is partial.
38115Splenic repair
38115 covers repair of a ruptured spleen, with or without partial removal. Do not separately code 38101 for partial removal included in that repair.
38120Splenectomy
38120 identifies a laparoscopic splenectomy. Use 38101 for the open partial procedure.

Codes related to 38101

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 38101
CodeHow it relatesNational office range
Same family
38100SplenectomyReports complete rather than partial removal of the spleen.No office rate
Used instead
38102SplenectomyFor total splenectomy performed with another procedure.No office rate
38115Splenic repairFor repair of a ruptured spleen, including repair with partial splenectomy.No office rate
38120SplenectomyIdentifies the laparoscopic splenectomy approach.No office rate

38101 billing questions

How is this code distinguished from total splenectomy?

Use this code when the surgeon removes only part of the spleen and preserves viable splenic tissue. Complete removal is reported with 38100, or 38102 when performed with another procedure.

Can partial splenectomy be reported separately with splenic repair?

Code 38115 describes repair of a ruptured spleen with or without partial splenectomy. Do not separately report 38101 for partial removal included in that repair service.

Does the laparoscopic approach use this code?

No. Code 38120 identifies laparoscopic splenectomy; 38101 is for the open partial procedure.

What documentation supports reporting partial rather than total removal?

The operative report should establish the open approach, the portion removed, the viable spleen preserved, and the clinical reason for partial resection.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and related postoperative care for 90 days are included in the global period.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 38101PPRRVU2026_Oct_nonQPP.csv, line 4,704 (RVU26D)

Open CMS sourceHow we calculate rates

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