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CPT code 23430: Biceps surgery, open tendon fixation2026 Medicare rate & RVUs

Reports open surgical fixation of the long head of the biceps tendon, commonly performed for a painful or damaged tendon during shoulder surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities41.3K Medicare services in 2024

Medicare pays $696.41 for 23430 nationally in a facility.

Medicare rate · 23430

Biceps surgery, open tendon fixation

Office or facility?

Work RVUs
9.92
Total RVUs
20.85
Global days
090

National rate · 2026

$696.41

Facility setting, before claim adjustments.

See every locality for 23430 →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 23430 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 23430 covers

An orthopedic surgeon releases the long head of the biceps tendon from its shoulder attachment and secures it to the humerus through an open approach. The operation is commonly performed in an operating room for a diseased, unstable, or ruptured tendon causing shoulder symptoms. It may be performed as a standalone procedure or during a shoulder operation such as repair of a rotator cuff tear.

Report this code for the open tendon-fixation procedure, not for arthroscopic-only fixation or simple tendon release. The operative report should identify the long-head tendon, describe the open fixation and its site, and clarify any other procedures performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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 available; 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 23430 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

23430 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$630.24
AlaskaUnavailable$851.64
ArizonaUnavailable$677.58
ArkansasUnavailable$622.07
Atlanta, GAUnavailable$715.54
Austin, TXUnavailable$706.81
Bakersfield, CAUnavailable$705.38
Baltimore area, MDUnavailable$739.26
Beaumont, TXUnavailable$664.82
Brazoria, TXUnavailable$681.75

23430 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
23430 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 23430 rate is calculated

Each of 23430’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 · 23430

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.92

9.92 RVUs× 1.000 GPCI

Practice expense8.94

8.94 RVUs× 1.000 GPCI

Malpractice1.99

1.99 RVUs× 1.000 GPCI

Adjusted RVUs

20.8500

Conversion factor

$33.4009

Medicare rate

$696.41

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

Payment rules and modifiers for 23430

23430 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23430

Biceps surgery, open tendon fixation

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)2Paid.
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 · 23430

Biceps surgery, open tendon fixation

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

23430 without 50 · national facility

$696.41

Biceps surgery, open tendon fixation

23430-50 · Bilateral: 150%

$1,044.62

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

23430 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 23430

    Biceps surgery, open tendon fixation9.92 wRVU

    Not priced

  • 29828

    Biceps tenodesis, arthroscopic shoulder12.83 wRVU

    Not priced

  • 23440

    Biceps tenodesis, with tendon transfer10.37 wRVU

    Not priced

  • 23412

    Rotator cuff repair, chronic tear, open repair11.63 wRVU

    Not priced

How to choose

29828Biceps tenodesisArthroscopic shoulder
Use 23430 for open fixation of the long-head biceps tendon; 29828 describes arthroscopic tenodesis.
23440Biceps tenodesisWith tendon transfer
23430 fixes the tendon to another site. 23440 is used when the long-head tendon is released without fixation.
23412Rotator cuff repairChronic tear, open repair
23412 addresses repair of a chronic rotator cuff tear, not fixation of the long-head biceps tendon. Both procedures may be performed in one operation.

Codes related to 23430

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

Codes related to 23430
CodeHow it relatesNational office range
Used instead
29828Biceps tenodesis, arthroscopic shoulderArthroscopic approach for biceps tenodesis rather than open fixation.No office rate
23440Biceps tenodesis, with tendon transferLong-head biceps tenotomy releases the tendon without fixing it elsewhere.No office rate
Often billed with
23412Rotator cuff repair, chronic tear, open repairChronic rotator cuff repair may be performed during the same shoulder operation.No office rate

23430 billing questions

How does this code differ from arthroscopic biceps tenodesis?

This code describes open fixation of the long-head biceps tendon. For fixation performed arthroscopically, consider 29828 instead.

When is tendon release reported instead of fixation?

A release without securing the tendon elsewhere is a tenotomy, not a tenodesis. The long-head biceps tenotomy code is 23440.

Can this be reported with a rotator cuff repair?

It may be performed during the same shoulder operation as a rotator cuff repair. Document the separate tendon condition and the work performed; multiple-procedure payment reduction may apply.

What documentation supports this code?

Document the affected long-head tendon, the reason for surgery, the open approach, and how and where the tendon was secured. Include the distinct work when another shoulder procedure is performed.

How is bilateral surgery reported?

For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.

What postoperative care is included?

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

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 23430PPRRVU2026_Oct_nonQPP.csv, line 2,202 (RVU26D)

Open CMS sourceHow we calculate rates

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