CPT code 23465: Shoulder capsule repair, posterior instability2026 Medicare rate & RVUs in Missouri
Surgical tightening of the posterior shoulder capsule, with or without a bone-block technique, treats glenohumeral instability directed toward the back of the joint.
CMS doesn’t publish an office rate for 23465 in Missouri.
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 23465 covers
An orthopedic surgeon uses this procedure to tighten the posterior shoulder capsule when the humeral head is unstable toward the back of the glenohumeral joint. The repair may include a bone-block technique. It is generally performed in an operating room for patients with posterior instability; the operative report should make clear the direction of instability and the repair performed.
Report the code when the documented procedure is a posterior capsular repair, not an anterior or multidirectional repair. The operative note should support the capsule addressed and describe any bone-block 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 is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays 150%. 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 23465 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $998.90 |
| Metropolitan St. Louis, MO | Unavailable | $1,006.67 |
| Rest of Missouri | Unavailable | $969.21 |
How the 23465 rate is calculated
Each of 23465’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 · 23465
RVUs × geographic indexes × conversion factor
Work15.89
15.89 RVUs× 1.000 GPCI
Practice expense11.41
11.41 RVUs× 1.000 GPCI
Malpractice3.38
3.38 RVUs× 1.000 GPCI
Adjusted RVUs
30.6800
Conversion factor
$33.4009
Medicare rate
$1,024.74
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23465
23465 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23465
Shoulder capsule repair, posterior instability
| 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 · 23465
Shoulder capsule repair, posterior instability
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
23465 without 50 · national facility
$1,024.74
Shoulder capsule repair, posterior instability
23465-50 · Bilateral: 150%
$1,537.11
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).
23465 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 23466Shoulder stabilizationMultidirectional instability
- Choose 23465 for a posterior capsular repair. Code 23466 is for multidirectional instability.
- 23450Shoulder stabilizationAnterior Putti-Platt repair
- Code 23450 addresses anterior capsular repair; 23465 addresses posterior instability.
- 23455Shoulder stabilizationAnterior repair with labrum
- Code 23455 is an anterior repair that includes labral repair. It is not the posterior repair represented by 23465.
- 23460Shoulder stabilizationAnterior capsular repair with bone block
- Code 23460 describes an anterior repair with a bone-block technique; 23465 is selected for posterior capsular repair.
23465 billing questions
How does this differ from code 23466?
Use this code for a posterior capsular repair. Code 23466 describes repair for multidirectional shoulder instability.
Is this the code for an anterior Bankart-type repair?
No. This code is for posterior capsular repair; anterior repair with labral repair is represented by code 23455.
How is bilateral surgery reported?
Report bilateral surgery with 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.
Can an assistant surgeon or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeons are paid only when supporting documentation is provided.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment 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
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