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Billing code 38200: Splenic injectionMedicare rate & RVUs

Reports direct contrast injection into the spleen to opacify splenic and portal venous structures for radiographic evaluation.

CMS RVU26DEffective Oct 1, 2026109 payment localities22 Medicare services in 2024

Medicare pays $109.22 for 38200 nationally in a facility.

Medicare rate · 38200

Splenic injection

Swap in your local Medicare rate.

Work RVUs
2.57
Total RVUs
3.27
Global days
000

National rate · 2026

$109.22

Facility setting, before claim adjustments.

See every locality for 38200 → · 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 38200 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 38200 covers

This service is the direct injection of contrast into the spleen to make the splenic and portal venous circulation visible on x-ray imaging, traditionally for splenoportography. It is distinct from drawing a splenic specimen or performing a bone marrow procedure. The procedure is generally performed by a radiologist or another physician with expertise in image-guided splenic access in a hospital or other procedural setting. It is now uncommon in routine practice.

Report 38200 for the injection procedure, supported by documentation of splenic access and contrast administration for the imaging study. The radiologic interpretation is represented separately when the applicable imaging code is reported. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. 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 multiple-procedure reduction. Do not append modifier 50; bilateral adjustment is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity, and co-surgeon and team-surgery payment are 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 38200 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

38200 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$103.82
Alaska*Unavailable$149.54
ArizonaUnavailable$107.59
ArkansasUnavailable$103.17
AtlantaUnavailable$111.34
AustinUnavailable$109.37
BakersfieldUnavailable$109.19
Baltimore/Surr. CntysUnavailable$113.62
BeaumontUnavailable$107.27
BrazoriaUnavailable$108.01

38200 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
38200 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 38200 rate is calculated

Each of 38200’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 · 38200

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.57Practice expense 0.46Malpractice 0.24

3.2700 adjusted RVUs×$33.4009 conversion factor=$109.22

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

Payment rules and modifiers for 38200

The CMS indicators that decide how 38200 is paid alongside other services.

CMS payment indicators · 38200

Splenic injection

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

38200 without 51 · national facility

$109.22

Splenic injection

38200-51 · Second procedure: 50%

$54.61

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

38200 compared with similar codes

Compare codes

38200 vs 75810 vs 75726 vs 76942: national Medicare rates

Swap in your local Medicare rate.

  • 38200
    Splenic injection · 2.57 wRVU
    —
  • 75810
    · 0 wRVU
    —
  • 75726
    Visceral angiography · 2 wRVU
    $167.67
  • 76942
    Ultrasound needle guidance · 0.65 wRVU
    $64.13

How to choose

75810Vein x-ray spleen/liver
75810 represents radiological supervision and interpretation for splenoportography; 38200 represents the splenic contrast injection.
75726Visceral angiography
Use 75726 for catheter-based visceral angiography. Code 38200 describes direct splenic injection for splenoportography.
76942Ultrasound needle guidance
76942 describes ultrasound guidance for needle placement, not the splenic contrast injection itself.

Codes related to 38200

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

Codes related to 38200
CodeHow it relatesNational office range
Often billed with
75810Vein x-ray spleen/liverRepresents radiological supervision and interpretation for splenoportography.No office rate
76942Ultrasound needle guidanceUltrasound needle-placement guidance may accompany splenic access when performed and separately reportable.$57.69–$84.06
77002Fluoroscopy guidanceFluoroscopic needle-placement guidance may accompany splenic access when performed and separately reportable.$106.19–$167.75
Used instead
75726Visceral angiographyRepresents visceral angiography using a catheter-based imaging approach rather than direct splenic injection.$151.38–$214.16

38200 billing questions

Is 38200 the imaging interpretation?

No. It represents the splenic contrast injection. Splenoportography imaging supervision and interpretation is represented by 75810 when that service is performed and reported.

How is this different from a visceral angiogram?

38200 describes direct injection into the spleen for splenoportography. A catheter-based visceral angiographic study, such as 75726, is a different imaging approach.

Can modifier 50 be used?

No. CMS specifies that bilateral adjustment does not apply and modifier 50 is inappropriate for this service.

What same-day care is included?

The 0-day global period includes same-day preoperative and postoperative care. When other procedures occur in the same session, the standard multiple-procedure reduction applies to the lower-valued procedure or procedures.

Can an assistant or another surgeon be paid?

Assistant-at-surgery payment is available only when medical necessity is documented. CMS does not permit co-surgeon or team-surgery payment for this code.

What should the record support?

Document direct splenic access, contrast injection, and the purpose of opacifying the splenic and portal venous circulation for imaging.

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 38200PPRRVU2026_Oct_nonQPP.csv, line 4,709 (RVU26D)

Open CMS sourceHow we calculate rates

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