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CPT code 23335: Prosthesis removal, total shoulder prosthesis2026 Medicare rate & RVUs

Reports operative removal of a total shoulder prosthesis, including associated debridement, when the implant is removed rather than revised or replaced.

CMS RVU26DEffective Oct 1, 2026109 payment localities566 Medicare services in 2024

Medicare pays $1,148.32 for 23335 nationally in a facility.

Medicare rate · 23335

Prosthesis removal, total shoulder prosthesis

Office or facility?

Work RVUs
18.53
Total RVUs
34.38
Global days
090

National rate · 2026

$1,148.32

Facility setting, before claim adjustments.

See every locality for 23335 →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 23335 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 23335 covers

An orthopedic surgeon uses this code when removing a total shoulder prosthesis, including its humeral and glenoid components. The operation may be performed for an infected, loose, or failed implant, including as a stage before a later reconstruction. The service includes debridement associated with removing the prosthesis. Medicare claims for this procedure are predominantly facility-based.

Choose this code when the total prosthesis is removed; removal of only a humeral or glenoid component is represented by 23334. Operative documentation should identify the implant and establish that the total prosthesis was removed, along with the reason for surgery and the work performed. CMS assigns a 90-day global period, which includes 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 multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery is not paid; co-surgeons require 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 23335 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

23335 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,043.44
AlaskaUnavailable$1,427.81
ArizonaUnavailable$1,117.76
ArkansasUnavailable$1,030.59
Atlanta, GAUnavailable$1,181.82
Austin, TXUnavailable$1,158.72
Bakersfield, CAUnavailable$1,149.91
Baltimore area, MDUnavailable$1,217.41
Beaumont, TXUnavailable$1,103.06
Brazoria, TXUnavailable$1,122.08

23335 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
23335 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 23335 rate is calculated

Each of 23335’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 · 23335

RVUs × geographic indexes × conversion factor

Office or facility?

Work18.53

18.53 RVUs× 1.000 GPCI

Practice expense12.10

12.10 RVUs× 1.000 GPCI

Malpractice3.75

3.75 RVUs× 1.000 GPCI

Adjusted RVUs

34.3800

Conversion factor

$33.4009

Medicare rate

$1,148.32

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

Payment rules and modifiers for 23335

23335 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23335

Prosthesis removal, total shoulder prosthesis

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)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
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 · 23335

Prosthesis removal, total shoulder prosthesis

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

23335 without 50 · national facility

$1,148.32

Prosthesis removal, total shoulder prosthesis

23335-50 · Bilateral: 150%

$1,722.48

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

23335 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 23335

    Prosthesis removal, total shoulder prosthesis18.53 wRVU

    Not priced

  • 23334

    Prosthesis removal, shoulder joint15.11 wRVU

    Not priced

  • 23473

    Shoulder revision, one component revised24.38 wRVU

    Not priced

  • 23474

    Shoulder revision, both components26.53 wRVU

    Not priced

  • 20680

    Implant removal, deep implant5.81 wRVU

    $631.95

How to choose

23334Prosthesis removalShoulder joint
Use 23334 for removal of a humeral or glenoid component. Use 23335 when the total shoulder prosthesis is removed.
23473Shoulder revisionOne component revised
23473 describes revision of one shoulder arthroplasty component. 23335 describes removal of the total prosthesis rather than revision of one component.
23474Shoulder revisionBoth components
23474 describes revision of both components of a shoulder arthroplasty. 23335 is for removal of the total prosthesis, not revision replacement of both components.
20680Implant removalDeep implant
20680 is used for removal of deep fixation hardware such as plates, screws, or rods. A shoulder joint prosthesis is reported with the prosthesis-removal code.

Codes related to 23335

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

Codes related to 23335
CodeHow it relatesNational office range
Same family
23334Prosthesis removal, shoulder jointRemoval of a humeral or glenoid component rather than the total shoulder prosthesis.No office rate
Used instead
23473Shoulder revision, one component revisedRevision arthroplasty when the humeral or glenoid component is revised.No office rate
23474Shoulder revision, both componentsRevision arthroplasty when both shoulder components are revised.No office rate
20680Implant removal, deep implantRemoval of deep orthopedic fixation hardware, not a shoulder joint prosthesis.$558.02–$814.76

23335 billing questions

When should I report 23335 instead of 23334?

Report 23335 when the total shoulder prosthesis is removed. Code 23334 represents removal of a humeral or glenoid component rather than the total prosthesis.

Is debridement separately reported with 23335?

Debridement associated with removal of the shoulder prosthesis is included in this service. The operative note should support the implant removal and the extent of work performed.

Can 23335 be reported when the prosthesis is revised or replaced?

When the operation revises or replaces shoulder arthroplasty components, compare the applicable revision arthroplasty code, such as 23473 or 23474. Those codes describe revision work rather than removal alone.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are bilateral procedures and surgical assistance handled?

CMS pays bilateral reporting with modifier 50 at 150%. Assistant-at-surgery services are not paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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 23335PPRRVU2026_Oct_nonQPP.csv, line 2,191 (RVU26D)

Open CMS sourceHow we calculate rates

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