CPT code 38100 denotes an open splenectomy — a complete excision of the spleen via an incision into the abdominal cavity. This procedure is performed for acute and chronic indications including traumatic splenic rupture, hemolytic anemias refractory to medical therapy, and splenic malignancies. As a major abdominal operation, CPT 38100 is significant for hospital resource use, perioperative risk profiles, and policy considerations around surgical admission and reimbursement pathways.

Key national payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis covers payer coverage conventions, typical sites of service, and the clinical contexts that justify use of the code.

Readers will find a concise clinical context for CPT 38100, expected service setting and resource implications, common modifiers used with the code, and where available, payer-specific coverage patterns and administrative considerations. The publication summarizes benchmarks and policy-relevant items that affect billing and reimbursement for open splenectomy at a national level.