CPT code 23172: Sequestrectomy, scapula2026 Medicare rate & RVUs in California
Removal of a separated, devitalized bone fragment from the scapula, typically during surgical treatment of osteomyelitis or another process producing sequestrum.
CMS doesn’t publish an office rate for 23172 in California.
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
On this page 9 sections
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 in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $555.43 |
| Chico, CA | Unavailable | $551.29 |
| El Centro, CA | Unavailable | $551.54 |
| Fresno, CA | Unavailable | $551.29 |
| Hanford, CA | Unavailable | $551.29 |
| Los Angeles, CA | Unavailable | $585.83 |
| Madera, CA | Unavailable | $551.29 |
| Marin County, CA | Unavailable | $646.87 |
| Merced, CA | Unavailable | $551.29 |
| Modesto, CA | Unavailable | $551.29 |
| Napa, CA | Unavailable | $618.02 |
| Oxnard, CA | Unavailable | $580.42 |
| Redding, CA | Unavailable | $551.29 |
| Rest of California | Unavailable | $551.29 |
| Riverside, CA | Unavailable | $567.41 |
| Sacramento, CA | Unavailable | $573.07 |
| Salinas, CA | Unavailable | $570.85 |
| San Benito County, CA | Unavailable | $662.54 |
| San Diego, CA | Unavailable | $580.44 |
| San Francisco, CA | Unavailable | $645.17 |
| San Luis Obispo, CA | Unavailable | $562.37 |
| Santa Clara County, CA | Unavailable | $655.58 |
| Santa Cruz, CA | Unavailable | $582.89 |
| Santa Maria, CA | Unavailable | $571.94 |
| Santa Rosa, CA | Unavailable | $588.38 |
| Stockton, CA | Unavailable | $551.29 |
| Vallejo, CA | Unavailable | $615.56 |
| Visalia, CA | Unavailable | $551.29 |
| Yuba City, CA | Unavailable | $551.29 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share 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.
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).
23172 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
Fee sheets · Coming soon
Put 23172 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist