38101 Splenectomy Medicare reimbursement rates in Colorado

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.