CPT code 23440: Biceps tenodesis, with tendon transfer2026 Medicare rate & RVUs

Medicare pays $701.42 for 23440 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 23440 covers

This operation addresses disease or instability involving the long head of the biceps tendon at the shoulder. The surgeon releases the tendon from its usual attachment and relocates or secures it as part of a tendon transfer. Orthopedic surgeons commonly perform the procedure in a hospital outpatient department or ambulatory surgery center, often during surgery for associated shoulder pathology. The operative report should establish the tendon treated and describe the transfer and fixation performed.

Report this service when the documented work supports a tendon transfer, rather than a routine biceps tenodesis alone. The 90-day global period includes 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 multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 23440 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

23440 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 23440 rate is calculated

Each of 23440’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.

Payment rules and modifiers for 23440

23440 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

23440 compared with similar codes

How to choose

23430Biceps surgeryOpen tendon fixation

Use 23430 for routine tenodesis of the long-head biceps tendon. This code describes the transfer-based shoulder procedure.

23405Shoulder tenotomySingle tendon

Code 23405 represents a shoulder-area tendon incision, not relocation and securing of the biceps tendon as part of a transfer.

23410Rotator cuff repairAcute tear, open

Code 23410 reports repair of an acute rotator cuff rupture. It does not represent biceps tendon transfer, though both procedures may be performed in one session.

Codes related to 23440

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

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

Open CMS sourceHow we calculate rates