CPT code 23466: Shoulder stabilization, multidirectional instability2026 Medicare rate & RVUs in Missouri
Open capsular stabilization for glenohumeral instability in multiple directions, reported when the surgeon tightens the capsule to control abnormal shoulder translation.
CMS doesn’t publish an office rate for 23466 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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On this page 9 sections
What 23466 covers
The surgeon tightens or repairs the glenohumeral capsule to limit abnormal movement in more than one direction. This open stabilization is used for multidirectional shoulder instability, such as recurrent slipping with laxity across several directions of motion. Orthopedic surgeons typically perform it in an operating room. The operative report should identify the instability pattern and describe the capsular work performed; a single-direction repair or a procedure centered on a different structure may point to another code.
Report 23466 for the open capsular stabilization performed for multidirectional instability, supported by the diagnosis and operative details. It has 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%. For bilateral surgery, modifier 50 is paid at 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 23466 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 | $1,007.02 |
| Metropolitan St. Louis, MO | Unavailable | $1,015.04 |
| Rest of Missouri | Unavailable | $974.74 |
How the 23466 rate is calculated
Each of 23466’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 · 23466
RVUs × geographic indexes × conversion factor
Work15.41
15.41 RVUs× 1.000 GPCI
Practice expense12.43
12.43 RVUs× 1.000 GPCI
Malpractice3.14
3.14 RVUs× 1.000 GPCI
Adjusted RVUs
30.9800
Conversion factor
$33.4009
Medicare rate
$1,034.76
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23466
23466 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23466
Shoulder stabilization, multidirectional 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 · 23466
Shoulder stabilization, multidirectional 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
23466 without 50 · national facility
$1,034.76
Shoulder stabilization, multidirectional instability
23466-50 · Bilateral: 150%
$1,552.14
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).
23466 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23465Shoulder capsule repairPosterior instability
- Choose 23466 for capsular stabilization addressing instability in multiple directions; 23465 is directed at posterior instability.
- 23455Shoulder stabilizationAnterior repair with labrum
- 23455 describes anterior capsular stabilization with labral repair. 23466 is selected for open stabilization of multidirectional instability.
- 29806Shoulder stabilizationArthroscopic capsulorrhaphy
- Both address shoulder instability, but 29806 is the arthroscopic approach; 23466 describes open capsular stabilization for multidirectional instability.
23466 billing questions
When is 23466 a better fit than an anterior capsular repair?
Use 23466 when the operative indication and capsular work address instability in multiple directions. A repair directed at anterior instability, particularly one with labral repair, is a different service.
How does 23466 differ from posterior capsular repair?
23466 is for multidirectional instability. A procedure directed specifically at posterior instability is represented by 23465.
What documentation supports reporting 23466?
Document the multidirectional instability and describe the open capsular stabilization performed. The operative note should make clear that the procedure addressed instability in multiple directions.
Can modifier 50 be used when both shoulders are treated?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150% when performed bilaterally.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the 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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