CPT code 23460: Shoulder stabilization, anterior capsular repair with bone block2026 Medicare rate & RVUs in California
Reported for operative stabilization of recurrent anterior shoulder instability when the surgeon adds a bone block to reinforce the glenoid.
CMS doesn’t publish an office rate for 23460 in California.
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 23460 covers
An orthopedic surgeon performs this stabilization for recurrent anterior shoulder dislocation or instability when a bone block is used to support the front of the glenoid. The added bone provides a structural buttress, while the capsular repair addresses the shoulder’s soft-tissue restraint. This procedure is typically performed in an operating room, such as a hospital or ambulatory surgery center, rather than an office setting.
Report the code when the operative report supports anterior capsular stabilization with a bone block; a soft-tissue repair alone or a coracoid transfer represents a different procedure. Documentation should identify the instability, the bone-block work, and the structures repaired. 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 the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 applies to bilateral procedures, 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 23460 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $1,003.75 |
| Chico, CA | Unavailable | $994.72 |
| El Centro, CA | Unavailable | $995.27 |
| Fresno, CA | Unavailable | $994.72 |
| Hanford, CA | Unavailable | $994.72 |
| Los Angeles, CA | Unavailable | $1,053.82 |
| Madera, CA | Unavailable | $994.72 |
| Marin County, CA | Unavailable | $1,144.55 |
| Merced, CA | Unavailable | $994.72 |
| Modesto, CA | Unavailable | $994.72 |
| Napa, CA | Unavailable | $1,098.84 |
| Oxnard, CA | Unavailable | $1,042.26 |
| Redding, CA | Unavailable | $994.72 |
| Rest of California | Unavailable | $994.72 |
| Riverside, CA | Unavailable | $1,029.96 |
| Sacramento, CA | Unavailable | $1,029.70 |
| Salinas, CA | Unavailable | $1,025.62 |
| San Benito County, CA | Unavailable | $1,172.75 |
| San Diego, CA | Unavailable | $1,039.68 |
| San Francisco, CA | Unavailable | $1,140.82 |
| San Luis Obispo, CA | Unavailable | $1,010.89 |
| Santa Clara County, CA | Unavailable | $1,157.52 |
| Santa Cruz, CA | Unavailable | $1,041.53 |
| Santa Maria, CA | Unavailable | $1,026.71 |
| Santa Rosa, CA | Unavailable | $1,051.06 |
| Stockton, CA | Unavailable | $994.72 |
| Vallejo, CA | Unavailable | $1,093.47 |
| Visalia, CA | Unavailable | $994.72 |
| Yuba City, CA | Unavailable | $994.72 |
How the 23460 rate is calculated
Each of 23460’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 · 23460
RVUs × geographic indexes × conversion factor
Work15.42
15.42 RVUs× 1.000 GPCI
Practice expense11.26
11.26 RVUs× 1.000 GPCI
Malpractice3.28
3.28 RVUs× 1.000 GPCI
Adjusted RVUs
29.9600
Conversion factor
$33.4009
Medicare rate
$1,000.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23460
23460 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23460
Shoulder stabilization, anterior capsular repair with bone block
| 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) | 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 · 23460
Shoulder stabilization, anterior capsular repair with bone block
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
23460 without 50 · national facility
$1,000.69
Shoulder stabilization, anterior capsular repair with bone block
23460-50 · Bilateral: 150%
$1,501.04
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).
23460 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23450Shoulder stabilizationAnterior Putti-Platt repair
- 23450 describes anterior capsular stabilization without a bone block. Choose 23460 when the operative work includes the bone-block component.
- 23455Shoulder stabilizationAnterior repair with labrum
- 23455 includes anterior labral repair, as in a Bankart-type repair. This code is distinguished by use of a bone block for anterior stabilization.
- 23462Shoulder stabilizationCoracoid process transfer
- 23462 describes anterior stabilization using transfer of the coracoid process. This code is for stabilization with a bone block rather than that transfer.
23460 billing questions
How is this code distinguished from 23455?
This code represents anterior stabilization that includes a bone block. Code 23455 is used for anterior capsular repair with labral repair, such as a Bankart-type procedure, without the bone-block distinction.
How is this different from a coracoid transfer?
Use this code when the documented stabilization includes a bone block rather than transfer of the coracoid process. The coracoid-transfer procedure is reported with 23462.
What should the operative report document?
Document the recurrent anterior instability, the bone block placed to support the glenoid, and the capsular repair or stabilization performed.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are part of the surgical episode.
Can this procedure be reported bilaterally or with another procedure?
For bilateral performance, modifier 50 is paid at 150%. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%; an assistant may be paid, while co-surgeon payment requires supporting documentation.
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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