No office rate
Choose 38115 for repair of the ruptured spleen; choose 38100 when the entire spleen is removed.
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CMS RVU26D · Effective 2026-10-01
38115 Splenic repair Medicare reimbursement rates in Hawaii
Reports operative repair of a ruptured spleen, commonly after blunt abdominal trauma, when the surgeon repairs the injured organ rather than removing it. Compare 38115 office and facility rates across CMS payment localities in Hawaii.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 38115 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1162.57
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
General surgery
About 38115: Operative repair of ruptured spleen
Reports operative repair of a ruptured spleen, commonly after blunt abdominal trauma, when the surgeon repairs the injured organ rather than removing it.
CPT 38115 represents operative repair of a ruptured spleen, commonly after blunt abdominal trauma, when the surgeon repairs the injured organ instead of removing it. A trauma or general surgeon typically performs the procedure in an operating room during urgent hospital care. The service is directed at treating the splenic injury while retaining the spleen, rather than performing a partial or total splenectomy.
Report the code when the operative report supports repair of the ruptured spleen; documentation should distinguish repair from removal of all or part of the organ. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this single-organ procedure.
CMS billing rules for 38115
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU21.33 · 59%
- Practice expense (office) RVU8.95 · 25%
- Malpractice RVU5.70 · 16%
76
Medicare services in 2024 · #5095 by national volume
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.
38115 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
38101 is for removal of part of the spleen. It does not describe repair of the ruptured organ.
No office rate
38120 describes laparoscopic splenectomy. The deciding distinction is removal by laparoscopy versus repair of the rupture under 38115.
Compare 38115 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1162.57
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 38115 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,706
- Code
- 38115
- Physician work
- 21.33
- Practice expense
- 8.95
- Malpractice
- 5.70
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.33 | × 1.000 | 21.3300 |
| Practice expense | 8.95 | × 1.137 | 10.1761 |
| Malpractice | 5.70 | × 0.579 | 3.3003 |
| Total RVUs | 34.8064 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1162.57
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.33 | 1 |
| Practice expense | 8.95 | 1.137 |
| Malpractice | 5.7 | 0.579 |
(21.33 × 1 + 8.95 × 1.137 + 5.7 × 0.579) × $33.4009 = $1162.57
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
38115 billing questions
How does 38115 differ from splenectomy?
Use 38115 when the ruptured spleen is repaired. Use a splenectomy code when all or part of the spleen is removed.
What documentation supports 38115?
The operative report should identify the splenic rupture and document that the surgeon repaired the spleen. It should make clear whether any portion or all of the organ was removed instead.
Should modifier 50 be reported?
No. Medicare's bilateral adjustment does not apply to this single-spleen procedure, and modifier 50 is inappropriate.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the session are paid at 50% under the standard multiple-procedure reduction.
Can 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.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,70338100,,Removal of spleen total,A,,19.06,8.29,NA,8.29,,4.80,32.15,32.15,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,70438101,,Removal of spleen partial,A,,19.06,8.39,NA,8.39,,5.08,32.53,32.53,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,70538102,,Removal of spleen total,A,,4.67,1.27,NA,1.27,,1.13,7.07,7.07,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,70638115,,Repair of ruptured spleen,A,,21.33,8.95,NA,8.95,,5.70,35.98,35.98,0,090,0.11,0.73,0.16,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,70738120,,Laparoscopy splenectomy,A,,16.64,9.02,NA,9.02,,4.24,29.90,29.90,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,70838129,,Unlisted laps px spleen,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,70938200,,Injection for spleen x-ray,A,,2.57,0.46,NA,0.46,,0.24,3.27,3.27,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014