CPT code 23474: Shoulder revision, both components2026 Medicare rate & RVUs in Texas
Reports revision of a total shoulder replacement when the surgeon revises both the humeral and glenoid components during the same operation.
CMS doesn’t publish an office rate for 23474 in Texas.
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 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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $1,561.63 |
| Beaumont, TX | Unavailable | $1,495.61 |
| Brazoria, TX | Unavailable | $1,515.32 |
| Dallas, TX | Unavailable | $1,532.65 |
| Fort Worth, TX | Unavailable | $1,530.13 |
| Galveston, TX | Unavailable | $1,524.92 |
| Houston, TX | Unavailable | $1,623.39 |
| Rest of Texas | Unavailable | $1,509.91 |
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.
How the rate is built · 23474
RVUs × geographic indexes × conversion factor
Work26.53
26.53 RVUs× 1.000 GPCI
Practice expense14.56
14.56 RVUs× 1.000 GPCI
Malpractice5.38
5.38 RVUs× 1.000 GPCI
Adjusted RVUs
46.4700
Conversion factor
$33.4009
Medicare rate
$1,552.14
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23474
23474 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23474
Shoulder revision, both components
| 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 · 23474
Shoulder revision, both components
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
23474 without 50 · national facility
$1,552.14
Shoulder revision, both components
23474-50 · Bilateral: 150%
$2,328.21
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).
23474 compared with similar codes
Compare codes · National
4 codes, side by side
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.
23474 billing questions
When should I report 23474 rather than 23473?
Use 23474 when the surgeon revises both the humeral and glenoid components. Use 23473 when the revision is limited to one of those components.
Does this code describe an initial total shoulder replacement?
No. It describes revision of an existing total shoulder replacement involving both components. An initial total shoulder replacement is reported with 23472.
Is graft use included in the revision service?
The code includes graft use when performed as part of the revision. The operative report should document the graft and the components revised.
What postoperative care is included in the global period?
CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS handle bilateral reporting and multiple procedures?
Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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