CPT code 23474: Shoulder revision, both components2026 Medicare rate & RVUs

Medicare pays $1,552.14 for 23474 nationally in a facility.

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

What 23474 covers

An orthopedic surgeon uses this code when revising both components of a prior total shoulder replacement. The operation may address implant loosening, wear, instability, or another failure requiring revision of the humeral and glenoid sides. It is generally performed in an operating room, most often in a hospital or ambulatory surgery setting. A conversion between shoulder replacement designs may qualify when both components are revised.

Select this code based on the components actually revised, not simply the complexity of the case or the original implant type. The operative report should identify the existing arthroplasty and describe revision of both the humeral and glenoid components; it should also document graft use when applicable. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed 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 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 23474 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

23474 rates by state

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

How the 23474 rate is calculated

Each of 23474’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 23474

23474 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

23474 compared with similar codes

How to choose

23473Shoulder revisionOne component revised

Report 23473 when the surgeon revises only the humeral or glenoid component. Report 23474 when both components are revised.

23472Shoulder arthroplastyPrimary, both joint surfaces

23472 describes an initial total shoulder replacement. 23474 is for revision of an existing replacement when both components are revised.

23470Shoulder arthroplastyHemiarthroplasty

23470 describes a shoulder hemiarthroplasty, not revision of both components of a total shoulder replacement.

Codes related to 23474

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

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