CPT code 23405: Shoulder tenotomy, single tendon2026 Medicare rate & RVUs in Massachusetts
Reports surgical division of one tendon in the shoulder area, such as a tendon release performed to address shoulder pain or restricted movement.
CMS doesn’t publish an office rate for 23405 in Massachusetts.
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 23405 covers
This procedure surgically divides one tendon in the shoulder area. An orthopedic surgeon or other qualified surgeon may perform it to release a tendon contributing to pain or restricted shoulder motion. A tenotomy may also be part of operative treatment for shoulder tendon disease, including treatment involving the long head of the biceps. The operative report should identify the tendon and describe the division performed.
Report this code when the procedure involves one tendon; the code for multiple tendons or muscles is a distinct choice. Documentation should support the shoulder location, the tendon treated, and the operative work. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires 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 23405 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | $627.54 |
| Rest of Massachusetts | Unavailable | $581.31 |
How the 23405 rate is calculated
Each of 23405’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 · 23405
RVUs × geographic indexes × conversion factor
Work8.33
8.33 RVUs× 1.000 GPCI
Practice expense7.31
7.31 RVUs× 1.000 GPCI
Malpractice1.56
1.56 RVUs× 1.000 GPCI
Adjusted RVUs
17.2000
Conversion factor
$33.4009
Medicare rate
$574.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23405
23405 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23405
Shoulder tenotomy, single tendon
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 23405
Shoulder tenotomy, single tendon
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 51 · payment effect
With and without the modifier
23405 without 51 · national facility
$574.50
Shoulder tenotomy, single tendon
23405-51 · Second procedure: 50%
$287.25
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
23405 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 23406Tendon releaseMultiple shoulder tendons
- Use 23405 for one tendon in the shoulder area; 23406 covers multiple tendons or muscles.
- 23430Biceps surgeryOpen tendon fixation
- 23405 represents tendon division. 23430 is used when the biceps tendon is repaired by tenodesis rather than simply divided.
- 23415Shoulder decompressionOpen ligament release
- 23415 addresses release of a shoulder ligament, not division of a tendon.
- 23412Rotator cuff repairChronic tear, open repair
- 23412 describes repair of a chronic rotator cuff tear. It is not a substitute for reporting a distinct single-tendon division.
23405 billing questions
When should I report this instead of 23406?
Report 23405 for division of a single tendon in the shoulder area. The multiple-tendon or muscle procedure is represented by 23406.
Can this code describe a biceps tenotomy?
It may describe surgical division of a single tendon in the shoulder area, including the long head of the biceps. The operative note should identify the tendon and the work performed.
Is modifier 50 appropriate for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code.
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 multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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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