CPT code 23155: Bone lesion excision, humerus with autograft2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $698.61 for 23155 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 23155 nationwide

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

What 23155 covers

An orthopedic surgeon exposes the humerus, removes or curettes a bone cyst or benign tumor, and uses the patient’s own bone graft to fill the defect. The service is generally performed in an operating room, including a hospital outpatient department or ambulatory surgery center. The autograft is the distinguishing feature; a similar humeral lesion procedure without graft or with donor bone is coded differently.

Select this code when the operative report supports the humeral site, lesion removal or curettage, and use of autograft. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Modifier 50 applies to bilateral procedures, paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation. Team surgery is 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.

How South Dakota compares for 23155

Across 109 of 109 payment localities, the facility rate for 23155 runs from $667.00 in Arkansas to $912.41 in Alaska. South Dakota pays $698.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

23155 rates by state

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

See 23155 in every payment locality

How the 23155 rate is calculated

Each of 23155’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 23155

23155 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

Codes related to 23155

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

How 23155 has changed in South Dakota

Price 23155 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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