CPT code 23146: Bone lesion removal, scapula with allograft2026 Medicare rate & RVUs

Medicare pays $596.21 for 23146 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 23146 covers

An orthopedic surgeon removes or curettes a benign bone cyst or tumor in the scapula and fills the resulting bone defect with allograft. The service is performed in an operative setting when the lesion requires surgical treatment; it is distinct from removing a lesion in the clavicle or humerus. The allograft is the differentiating feature of this scapular lesion procedure.

Select the code when the operative report supports the scapular site, removal or curettage of a benign lesion, and placement of allograft. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

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 23146 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

23146 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 23146 rate is calculated

Each of 23146’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.

Payment rules and modifiers for 23146

23146 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

23146 compared with similar codes

How to choose

23145Bone lesion removalScapula with autograft

Both address a benign lesion in the scapula, but 23146 is distinguished by use of allograft. Select the code that matches the graft approach documented in the operative report.

23150Bone lesion removalProximal humerus, no graft

This code applies to a lesion in the proximal humerus, not the scapula.

23155Bone lesion excisionHumerus with autograft

This is a humeral lesion procedure; 23146 is for a scapular lesion treated with allograft.

Codes related to 23146

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates