CPT code 23472: Shoulder arthroplasty, primary, both joint surfaces2026 Medicare rate & RVUs in Connecticut

In Connecticut, Medicare pays $1,378.70 for 23472 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 23472 nationwide

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

What 23472 covers

An orthopedic surgeon replaces the humeral and glenoid surfaces of the shoulder’s glenohumeral joint with prosthetic components. The procedure is performed in an operating room, commonly for advanced shoulder arthritis or other joint damage when total replacement is chosen. Both conventional and reverse-design total shoulder constructs are reported with this code; the operative report should identify the replacement performed and the components implanted.

Report the primary total replacement, rather than a humeral-side-only replacement or a revision procedure. Documentation should support the condition treated, the operative approach, and replacement of both joint surfaces. 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 one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; 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.

How Connecticut compares for 23472

Across 109 of 109 payment localities, the facility rate for 23472 runs from $1,168.49 in Arkansas to $1,623.51 in Alaska. Connecticut pays $1,378.70. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

23472 rates by state

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

See 23472 in every payment locality

How the 23472 rate is calculated

Each of 23472’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 23472

23472 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

Codes related to 23472

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

How 23472 has changed in Connecticut

Price 23472 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

• Ansonia
• Ball Pond
• Baltic
• Bantam
• Bethel
• Bethlehem Village
• Bigelow Corners
• Blue Hills

Browse all communities in Connecticut

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