No office rate
Both describe total splenectomy, but 38120 is for the laparoscopic approach and 38100 is for an open approach.
On this page
CMS RVU26D · Effective 2026-10-01
38120 Splenectomy Medicare reimbursement rates in Michigan
Report this code when a surgeon removes the spleen using a laparoscopic approach, commonly for hematologic disease or a splenic lesion. Compare 38120 office and facility rates across CMS payment localities in Michigan.
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 38120 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$990.74–$1085.29
2 of 2 localities have a supported rate.
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 38120: Laparoscopic total splenectomy
Report this code when a surgeon removes the spleen using a laparoscopic approach, commonly for hematologic disease or a splenic lesion.
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.
CMS billing rules for 38120
- 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 RVU16.64 · 56%
- Practice expense (office) RVU9.02 · 30%
- Malpractice RVU4.24 · 14%
420
Medicare services in 2024 · #3695 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.
38120 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
Use 38101 when only part of the spleen is removed; 38120 describes complete removal using laparoscopy.
No office rate
38115 describes repair of a ruptured spleen. It is not the code for removing the spleen laparoscopically.
38129
No office rateUnlisted laps px spleen
38129 is an unlisted laparoscopic spleen procedure code. Use 38120 for a laparoscopic splenectomy rather than the unlisted code.
Compare 38120 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
Unavailable
Facility
$1085.29
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$990.74
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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 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.
4,70438101,,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
4,71038204,,Bl donor search management,B,+,1.95,0.42,NA,0.42,,0.21,2.58,2.58,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00