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CPT code 23172: Sequestrectomy, scapula2026 Medicare rate & RVUs

Removal of a separated, devitalized bone fragment from the scapula, typically during surgical treatment of osteomyelitis or another process producing sequestrum.

CMS RVU26DEffective Oct 1, 2026109 payment localities14 Medicare services in 2024

Medicare pays $545.77 for 23172 nationally in a facility.

Medicare rate · 23172

Sequestrectomy, scapula

Office or facility?

Work RVUs
7.13
Total RVUs
16.34
Global days
090

National rate · 2026

$545.77

Facility setting, before claim adjustments.

See every locality for 23172 →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 23172 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 23172 covers

Code 23172 represents operative removal of a sequestrum, a discrete piece of devitalized bone, from the scapula. An orthopedic surgeon typically performs the procedure when infection, such as chronic osteomyelitis, has left nonviable scapular bone requiring surgical removal. The documented operative site must be the scapula; sequestrectomy of the clavicle or humeral head has a different code. These procedures are generally performed in an operating-room setting.

Report the code when the operative record identifies scapular sequestrum and describes its removal. Documentation should establish the site, the presence of devitalized bone, and the work performed. This is major surgery: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 23172 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

23172 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$491.84
AlaskaUnavailable$659.09
ArizonaUnavailable$530.57
ArkansasUnavailable$485.16
Atlanta, GAUnavailable$560.68
Austin, TXUnavailable$555.47
Bakersfield, CAUnavailable$555.43
Baltimore area, MDUnavailable$580.25
Beaumont, TXUnavailable$519.04
Brazoria, TXUnavailable$534.34

23172 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
23172 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 23172 rate is calculated

Each of 23172’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 · 23172

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.13

7.13 RVUs× 1.000 GPCI

Practice expense7.71

7.71 RVUs× 1.000 GPCI

Malpractice1.50

1.50 RVUs× 1.000 GPCI

Adjusted RVUs

16.3400

Conversion factor

$33.4009

Medicare rate

$545.77

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

Payment rules and modifiers for 23172

23172 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23172

Sequestrectomy, scapula

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 · 23172

Sequestrectomy, scapula

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

23172 without 50 · national facility

$545.77

Sequestrectomy, scapula

23172-50 · Bilateral: 150%

$818.66

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

23172 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 23172

    Sequestrectomy, scapula7.13 wRVU

    Not priced

  • 23170

    Sequestrectomy, clavicle7.03 wRVU

    Not priced

  • 23174

    Sequestrectomy, humeral head or surgical neck9.8 wRVU

    Not priced

  • 23182

    Bone excision, scapula, partial removal8.39 wRVU

    Not priced

  • 23190

    Bone removal, partial scapula7.28 wRVU

    Not priced

How to choose

23170SequestrectomyClavicle
Both describe sequestrectomy, but 23170 is for the clavicle; 23172 is for the scapula.
23174SequestrectomyHumeral head or surgical neck
23174 applies to sequestrectomy of the humeral head or surgical neck, not the scapula.
23182Bone excisionScapula, partial removal
23182 describes partial excision of scapular bone. Choose 23172 when the operative target is a sequestrum.
23190Bone removalPartial scapula
23190 describes partial ostectomy of the scapula; 23172 is specific to removal of a sequestrum.

Codes related to 23172

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

Codes related to 23172
CodeHow it relatesNational office range
Same family
23170Sequestrectomy, clavicleSequestrectomy of the clavicle rather than the scapula.No office rate
23174Sequestrectomy, humeral head or surgical neckSequestrectomy of the humeral head or surgical neck rather than the scapula.No office rate
Used instead
23182Bone excision, scapula, partial removalPartial excision of scapular bone when the procedure is not specifically sequestrectomy.No office rate
23190Bone removal, partial scapulaPartial scapular ostectomy, a different bone-removal procedure.No office rate

23172 billing questions

How is this code distinguished from clavicular or humeral sequestrectomy?

The site determines the code: 23172 is for sequestrum removed from the scapula. Clavicular and humeral-head/surgical-neck sequestrectomy have separate codes.

When would a scapular bone excision code be considered instead?

Use the procedure that matches the documented work. Code 23172 describes removal of a sequestrum; a partial scapular excision or ostectomy code describes a different bone-removal procedure.

What should the operative report document?

Document the scapular site, the devitalized bone or sequestrum identified, and its operative removal. The record should distinguish this work from removal of bone at another shoulder-girdle site.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the surgical global period.

How is bilateral reporting handled?

When the procedure is bilateral, report modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted for this code.

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 23172PPRRVU2026_Oct_nonQPP.csv, line 2,178 (RVU26D)

Open CMS sourceHow we calculate rates

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