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CPT code 23156: Bone lesion surgery, humerus with allograft2026 Medicare rate & RVUs

Reports excision or curettage of a humeral bone cyst or benign tumor when the surgeon fills the resulting defect with allograft.

CMS RVU26DEffective Oct 1, 2026109 payment localities12 Medicare services in 2024

Medicare pays $642.63 for 23156 nationally in a facility.

Medicare rate · 23156

Bone lesion surgery, humerus with allograft

Office or facility?

Work RVUs
8.88
Total RVUs
19.24
Global days
090

National rate · 2026

$642.63

Facility setting, before claim adjustments.

See every locality for 23156 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 23156 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 23156 covers

An orthopedic surgeon typically performs this open procedure in an operating room to remove or curette a bone cyst or benign tumor in the humerus and fill the resulting defect with donor bone graft. The treatment may address a lesion in the upper arm bone that needs surgical removal and graft reconstruction; the operative report should identify the humeral site, lesion, removal method, and use of allograft.

Choose this code when the humeral lesion is treated by excision or curettage with allograft, rather than selecting a code for a different graft method or no graft. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; 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 23156 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

23156 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$579.77
AlaskaUnavailable$780.81
ArizonaUnavailable$624.74
ArkansasUnavailable$572.01
Atlanta, GAUnavailable$660.80
Austin, TXUnavailable$652.38
Bakersfield, CAUnavailable$650.58
Baltimore area, MDUnavailable$683.05
Beaumont, TXUnavailable$612.70
Brazoria, TXUnavailable$628.50

23156 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
23156 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 23156 rate is calculated

Each of 23156’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 · 23156

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.88

8.88 RVUs× 1.000 GPCI

Practice expense8.46

8.46 RVUs× 1.000 GPCI

Malpractice1.90

1.90 RVUs× 1.000 GPCI

Adjusted RVUs

19.2400

Conversion factor

$33.4009

Medicare rate

$642.63

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 23156

23156 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23156

Bone lesion surgery, humerus with allograft

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 23156

Bone lesion surgery, humerus with allograft

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

23156 without 50 · national facility

$642.63

Bone lesion surgery, humerus with allograft

23156-50 · Bilateral: 150%

$963.95

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

23156 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 23156

    Bone lesion surgery, humerus with allograft8.88 wRVU

    Not priced

  • 23150

    Bone lesion removal, proximal humerus, no graft8.69 wRVU

    Not priced

  • 23155

    Bone lesion excision, humerus with autograft10.59 wRVU

    Not priced

  • 23184

    Bone excision, proximal humerus9.65 wRVU

    Not priced

How to choose

23150Bone lesion removalProximal humerus, no graft
Use 23156 when the humeral cyst or benign tumor is excised or curetted and the defect is filled with allograft. Use 23150 for the corresponding service without graft.
23155Bone lesion excisionHumerus with autograft
Both describe humeral lesion treatment with grafting, but 23155 specifies autograft and 23156 specifies allograft.
23184Bone excisionProximal humerus
23184 describes partial excision of proximal humerus. Choose 23156 for curettage or excision of a bone cyst or benign tumor with allograft.

Codes related to 23156

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

Codes related to 23156
CodeHow it relatesNational office range
Same family
23150Bone lesion removal, proximal humerus, no graftHumeral cyst or benign-tumor excision or curettage without graft.No office rate
23155Bone lesion excision, humerus with autograftHumeral cyst or benign-tumor excision or curettage with autograft.No office rate
Used instead
23140Bone lesion removal, clavicular lesionComparable cyst or benign-tumor treatment in the clavicle rather than the humerus.No office rate
23145Bone lesion removal, scapula with autograftClavicular lesion treatment with autograft, not humeral allograft treatment.No office rate
23146Bone lesion removal, scapula with allograftClavicular lesion treatment with allograft, for a different bone site.No office rate
23184Bone excision, proximal humerusPartial excision of proximal humerus when the service is bone excision rather than lesion curettage with allograft.No office rate

23156 billing questions

How does 23156 differ from 23150?

23156 describes humeral cyst or benign-tumor excision or curettage with allograft. 23150 is the corresponding humeral service without graft.

How does 23156 differ from 23155?

The distinction is the graft source: 23156 uses allograft, while 23155 uses autograft.

Is the allograft part of the reported service?

Yes. Allograft use is the distinguishing feature of 23156; do not also report 23150 for the same lesion treatment.

What documentation supports reporting 23156?

Document the humeral lesion and its location, the excision or curettage performed, and that allograft was used to fill the defect.

What does the 90-day global period include?

It includes the day-before preoperative visit and 90 days of related postoperative care.

Can 23156 be reported for bilateral humeral lesions?

For bilateral treatment, modifier 50 is paid at 150%.

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
RVUs for 23156PPRRVU2026_Oct_nonQPP.csv, line 2,176 (RVU26D)

Open CMS sourceHow we calculate rates

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