Billing code 38100: SplenectomyMedicare rate & RVUs in Washington
Report this code for open operative removal of the entire spleen, such as for traumatic injury or disease requiring complete splenectomy.
CMS doesn’t publish an office rate for 38100 in Washington.
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 9 sections
What 38100 covers
Code 38100 represents an open abdominal operation in which the surgeon removes the spleen in its entirety. It may be performed for splenic trauma when preservation is not feasible, or for a hematologic condition or tumor requiring complete removal. General and trauma surgeons commonly perform it in a hospital operating room; the code distinguishes this approach from laparoscopic splenectomy and partial removal.
Select the code from the operative report’s documented extent and approach: the record should show complete splenic excision through an open operation. The 90-day global includes the day-before preoperative visit and related postoperative care through day 90. When another procedure is performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this single-organ service.
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 38100 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,058.47 |
| Seattle (King Cnty) | Unavailable | $1,139.19 |
How the 38100 rate is calculated
Each of 38100’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 · 38100
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.06Practice expense 8.29Malpractice 4.80
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 38100
38100 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 38100
Splenectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.73/0.16 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 38100
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
38100 without 51 · national facility
$1,073.84
Splenectomy
38100-51 · Second procedure: 50%
$536.92
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%).
38100 compared with similar codes
Compare codes
38100 vs 38101 vs 38102 vs 38120 vs 38115: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 38101Splenectomy
- Use 38101 when the surgeon removes only part of the spleen. Code 38100 requires removal of the entire organ.
- 38102Splenectomy
- 38102 describes total splenic removal with partial pancreatectomy. Use 38100 when the operative service does not include that pancreatic resection.
- 38120Splenectomy
- 38120 identifies a laparoscopic splenectomy. Code 38100 is for the open approach.
- 38115Splenic repair
- 38115 is for repairing a ruptured spleen rather than removing it. Choose based on whether the surgeon repairs and preserves the spleen or performs a splenectomy.
38100 billing questions
How does 38100 differ from 38120?
38100 is for an open operation. Use 38120 when the splenectomy is performed laparoscopically.
Can modifier 50 be reported?
No. The bilateral adjustment does not apply because the code describes removal of a single spleen; modifier 50 is inappropriate.
Is routine postoperative care separately reported?
Related postoperative care through day 90 is included in the global period, along with the day-before preoperative visit.
What documentation supports 38100?
The operative report should establish that the entire spleen was removed and that the surgeon used an open approach. It should also identify any additional procedures performed during the same session.
How is splenectomy coded when part of the pancreas is also removed?
Code 38102 describes total splenic removal with partial pancreatectomy. Review the operative report to determine whether that combined service was performed.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while 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
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