CPT code 23190: Bone removal, partial scapula2026 Medicare rate & RVUs in Texas
Reports operative removal of a limited portion of scapular bone, such as for a symptomatic bony prominence treated by an orthopedic surgeon.
CMS doesn’t publish an office rate for 23190 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 23190 covers
An orthopedic surgeon removes a limited portion of the scapula to address a bony prominence or contour that is causing symptoms. A familiar clinical situation is partial removal of a prominent scapular edge in a patient with painful snapping over the shoulder blade. The work is performed as an operation, typically in a facility setting, and the operative report should identify the portion of scapula removed and the reason for the bone resection.
Select this code when the procedure is a partial ostectomy, rather than removal of a defined bone lesion, resection of infected or necrotic bone, or removal of the acromion. The operative note should describe the bone removed, the extent of resection, and the clinical indication so the service can be distinguished from those procedures. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons are paid only with supporting documentation, and 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.
Where 23190 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $557.79 |
| Beaumont, TX | Unavailable | $521.94 |
| Brazoria, TX | Unavailable | $536.79 |
| Dallas, TX | Unavailable | $542.31 |
| Fort Worth, TX | Unavailable | $540.44 |
| Galveston, TX | Unavailable | $539.76 |
| Houston, TX | Unavailable | $567.95 |
| Rest of Texas | Unavailable | $530.51 |
How the 23190 rate is calculated
Each of 23190’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 · 23190
RVUs × geographic indexes × conversion factor
Work7.28
7.28 RVUs× 1.000 GPCI
Practice expense7.60
7.60 RVUs× 1.000 GPCI
Malpractice1.54
1.54 RVUs× 1.000 GPCI
Adjusted RVUs
16.4200
Conversion factor
$33.4009
Medicare rate
$548.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23190
23190 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23190
Bone removal, partial 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) | 1 | Permitted with supporting documentation. |
| 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 · 23190
Bone removal, partial 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
23190 without 50 · national facility
$548.44
Bone removal, partial scapula
23190-50 · Bilateral: 150%
$822.66
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).
23190 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23182Bone excisionScapula, partial removal
- This code describes partial scapular ostectomy for a symptomatic bony prominence or contour. Code 23182 is for partial bone excision, including procedures directed at infected bone.
- 23172SequestrectomyScapula
- Use 23172 when the operation removes a sequestrum from the scapula. This code describes partial removal of scapular bone for another operative purpose.
- 23140Bone lesion removalClavicular lesion
- Use 23140 when excision or curettage targets a scapular bone cyst or benign tumor. This code is for partial ostectomy rather than lesion-specific removal.
23190 billing questions
How is this different from scapular bone-lesion removal?
Use this code for partial removal of scapular bone that is not being coded as excision or curettage of a defined bone lesion. When the operative target is a bone cyst or benign tumor, consider the lesion-specific scapular code instead.
What should the operative note document?
Document the symptomatic bony prominence or other reason for surgery, the scapular portion removed, and the extent of resection. Those details distinguish partial ostectomy from lesion removal or removal of infected bone.
Can this be reported bilaterally?
CMS identifies this as a bilateral procedure. With modifier 50, payment is at 150%; document the work performed on each side.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the others at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; CMS does not permit team-surgery payment 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
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