CPT code 23406: Tendon release, multiple shoulder tendons2026 Medicare rate & RVUs in Texas
Reports operative release of multiple tendons in the shoulder region, such as for a contracture when several tendon structures require division.
CMS doesn’t publish an office rate for 23406 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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On this page 9 sections
What 23406 covers
Code 23406 describes an operation that divides or releases multiple tendons in the shoulder region. An orthopedic surgeon may perform it when a shoulder contracture or deformity requires release of several tendon structures. It is distinct from an operation that repairs a torn rotator cuff or secures a tendon to bone.
Select the code based on the operative report’s account of the shoulder-area tendons released; a release of one tendon points to the single-tendon sibling code. Documentation should identify the treated structures and the operative work performed. CMS assigns a 90-day global period, including 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 50% reduction. The bilateral adjustment does not apply, and modifier 50 is inappropriate. CMS permits assistant-at-surgery payment; 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 23406 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 | $684.55 |
| Beaumont, TX | Unavailable | $646.56 |
| Brazoria, TX | Unavailable | $663.63 |
| Dallas, TX | Unavailable | $669.17 |
| Fort Worth, TX | Unavailable | $667.15 |
| Galveston, TX | Unavailable | $666.53 |
| Houston, TX | Unavailable | $693.62 |
| Rest of Texas | Unavailable | $655.66 |
How the 23406 rate is calculated
Each of 23406’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 · 23406
RVUs × geographic indexes × conversion factor
Work10.73
10.73 RVUs× 1.000 GPCI
Practice expense7.97
7.97 RVUs× 1.000 GPCI
Malpractice1.48
1.48 RVUs× 1.000 GPCI
Adjusted RVUs
20.1800
Conversion factor
$33.4009
Medicare rate
$674.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23406
23406 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23406
Tendon release, multiple shoulder tendons
| 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) | 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 · 23406
Tendon release, multiple shoulder tendons
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
23406 without 51 · national facility
$674.03
Tendon release, multiple shoulder tendons
23406-51 · Second procedure: 50%
$337.02
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%).
23406 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 23405Shoulder tenotomySingle tendon
- Choose 23405 when one shoulder-area tendon is released; 23406 describes release of multiple tendons.
- 23410Rotator cuff repairAcute tear, open
- 23410 represents repair of an acute rotator cuff tear, while 23406 represents release rather than repair.
- 23412Rotator cuff repairChronic tear, open repair
- 23412 represents repair of a chronic rotator cuff tear; 23406 is for release of multiple shoulder-area tendons.
- 23440Biceps tenodesisWith tendon transfer
- 23440 is directed at the long-head biceps tendon; 23406 describes release of multiple tendons in the shoulder region.
23406 billing questions
How does 23406 differ from 23405?
23406 is for release of multiple shoulder-area tendons. Use 23405 when the operative work releases a single tendon.
Does 23406 describe rotator cuff repair?
No. It describes tendon release or division, not repair of a torn rotator cuff. The operative report should support the work actually performed.
Should modifier 50 be appended for both shoulders?
No. CMS identifies the bilateral adjustment as inapplicable to this code and modifier 50 as inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
CMS permits assistant-at-surgery payment for 23406. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full, and other procedures are paid at 50%.
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
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