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Billing code 38120: SplenectomyMedicare rate & RVUs

Report this code when a surgeon removes the spleen using a laparoscopic approach, commonly for hematologic disease or a splenic lesion.

CMS RVU26DEffective Oct 1, 2026109 payment localities420 Medicare services in 2024

Medicare pays $998.69 for 38120 nationally in a facility.

Medicare rate · 38120

Splenectomy

Swap in your local Medicare rate.

Work RVUs
16.64
Total RVUs
29.90
Global days
090

National rate · 2026

$998.69

Facility setting, before claim adjustments.

See every locality for 38120 → · 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 38120 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 38120 covers

This code represents laparoscopic surgical removal of the spleen, generally as a complete splenectomy. A surgeon performs the operation in a hospital or ambulatory surgery setting, using a camera and instruments inserted through small incisions to mobilize and remove the organ. Common clinical contexts include immune thrombocytopenia, hereditary spherocytosis, and selected splenic masses when splenectomy is indicated. The laparoscopic approach distinguishes this service from open removal, while the extent distinguishes it from partial splenic resection.

The operative report should support the laparoscopic approach and removal of the spleen. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Do not append modifier 50; the spleen is a single organ. 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 38120 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

38120 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$899.56
Alaska*Unavailable$1,232.58
ArizonaUnavailable$968.95
ArkansasUnavailable$887.52
AtlantaUnavailable$1,033.64
AustinUnavailable$1,001.13
BakersfieldUnavailable$982.80
Baltimore/Surr. CntysUnavailable$1,063.14
BeaumontUnavailable$961.52
BrazoriaUnavailable$969.27

38120 rates by state

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

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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
38120 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 38120 rate is calculated

Each of 38120’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 · 38120

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.64Practice expense 9.02Malpractice 4.24

29.9000 adjusted RVUs×$33.4009 conversion factor=$998.69

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

Payment rules and modifiers for 38120

38120 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 38120

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)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 38120

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

38120 without 51 · national facility

$998.69

Splenectomy

38120-51 · Second procedure: 50%

$499.35

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

38120 compared with similar codes

Compare codes

38120 vs 38100 vs 38101 vs 38115 vs 38129: national Medicare rates

Swap in your local Medicare rate.

  • 38120
    Splenectomy · 16.64 wRVU
    —
  • 38100
    Splenectomy · 19.06 wRVU
    —
  • 38101
    Splenectomy · 19.06 wRVU
    —
  • 38115
    Splenic repair · 21.33 wRVU
    —
  • 38129
    · 0 wRVU
    —

How to choose

38100Splenectomy
Both describe total splenectomy, but 38120 is for the laparoscopic approach and 38100 is for an open approach.
38101Splenectomy
Use 38101 when only part of the spleen is removed; 38120 describes complete removal using laparoscopy.
38115Splenic repair
38115 describes repair of a ruptured spleen. It is not the code for removing the spleen laparoscopically.
38129Unlisted laps px spleen
38129 is an unlisted laparoscopic spleen procedure code. Use 38120 for a laparoscopic splenectomy rather than the unlisted code.

Codes related to 38120

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

Codes related to 38120
CodeHow it relatesNational office range
Same family
38100SplenectomyTotal splenectomy performed through an open approach.No office rate
38101SplenectomyPartial splenic removal rather than complete splenectomy.No office rate
Used instead
38115Splenic repairRepairs a ruptured spleen when repair is selected instead of removal.No office rate
38129Unlisted laps px spleenUnlisted laparoscopic spleen procedure for services without a dedicated code.No office rate

38120 billing questions

How does this code differ from 38100?

Use 38120 for laparoscopic splenectomy. Code 38100 describes total splenectomy through an open approach.

Can this code be used for partial removal of the spleen?

No. This code represents complete splenectomy; 38101 describes partial splenic removal.

Should modifier 50 be reported?

No. Splenectomy involves one spleen, so modifier 50 is inappropriate.

What documentation supports reporting 38120?

The operative report should establish that the surgeon used a laparoscopic approach and removed the spleen. Include the clinical indication and the extent of resection.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

May an assistant or co-surgeon be reported?

An assistant at surgery may be paid. 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 38120PPRRVU2026_Oct_nonQPP.csv, line 4,707 (RVU26D)

Open CMS sourceHow we calculate rates

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