CPT code 23335: Prosthesis removal, total shoulder prosthesis2026 Medicare rate & RVUs in Missouri
Reports operative removal of a total shoulder prosthesis, including associated debridement, when the implant is removed rather than revised or replaced.
CMS doesn’t publish an office rate for 23335 in Missouri.
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 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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,120.79 |
| Metropolitan St. Louis, MO | Unavailable | $1,129.17 |
| Rest of Missouri | Unavailable | $1,089.29 |
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
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
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 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.
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).
23335 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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