CPT code 23470: Shoulder arthroplasty, hemiarthroplasty2026 Medicare rate & RVUs in Missouri
Shoulder hemiarthroplasty replaces the humeral joint surface while retaining the native glenoid, typically for selected cases of shoulder arthritis or humeral head damage.
CMS doesn’t publish an office rate for 23470 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 23470 covers
An orthopedic surgeon performs this operation to replace the humeral side of the glenohumeral joint while leaving the patient’s natural glenoid in place. It may be selected for severe shoulder arthritis or substantial humeral head damage when the surgeon plans a hemiarthroplasty rather than replacement of both joint surfaces. The procedure is generally performed in an operating room, with the operative report documenting the condition treated and the components replaced or retained.
Report the code for the hemiarthroplasty, not for a total shoulder replacement or revision of an existing prosthesis. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery payment 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 23470 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 | $1,061.56 |
| Metropolitan St. Louis, MO | Unavailable | $1,069.56 |
| Rest of Missouri | Unavailable | $1,031.45 |
How the 23470 rate is calculated
Each of 23470’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 · 23470
RVUs × geographic indexes × conversion factor
Work17.44
17.44 RVUs× 1.000 GPCI
Practice expense11.57
11.57 RVUs× 1.000 GPCI
Malpractice3.56
3.56 RVUs× 1.000 GPCI
Adjusted RVUs
32.5700
Conversion factor
$33.4009
Medicare rate
$1,087.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23470
23470 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23470
Shoulder arthroplasty, hemiarthroplasty
| 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 · 23470
Shoulder arthroplasty, hemiarthroplasty
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
23470 without 50 · national facility
$1,087.87
Shoulder arthroplasty, hemiarthroplasty
23470-50 · Bilateral: 150%
$1,631.80
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).
23470 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23472Shoulder arthroplastyPrimary, both joint surfaces
- Choose 23470 when the humeral side is replaced and the native glenoid is retained. Choose 23472 when both sides of the joint are replaced.
- 23473Shoulder revisionOne component revised
- 23473 describes revision of one component of an existing shoulder prosthesis; 23470 describes a primary hemiarthroplasty, not prosthesis revision.
- 23474Shoulder revisionBoth components
- 23474 is for revision involving both components of an existing shoulder prosthesis. It is not the primary replacement of the humeral side represented by 23470.
23470 billing questions
How does this differ from 23472?
This code represents replacement of the humeral side while retaining the native glenoid. Report 23472 when the operation replaces both sides of the shoulder joint.
What documentation supports hemiarthroplasty rather than total shoulder replacement?
The operative report should establish the shoulder condition treated and identify that the humeral joint surface was replaced while the native glenoid was retained.
Does the 90-day global period include postoperative visits?
Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the global period.
How is bilateral hemiarthroplasty handled?
When the procedure is performed bilaterally, CMS pays the service reported with modifier 50 at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery payment is not permitted.
What happens when another procedure is performed during the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and 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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