Billing code 23030: Shoulder drainageMedicare rate & RVUs

Medicare pays $473.96 for 23030 nationally in the office and $243.83 in a hospital or facility. Local office rates run $415.01–$624.78.

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

What 23030 covers

An orthopedic surgeon or other qualified surgeon makes an incision to reach and drain a deep abscess or hematoma in the shoulder region. The service addresses a collection in deep soft tissue, not drainage of an infected shoulder bursa or an abscess confined to the skin and superficial tissue. It may be performed in an operating room or another setting appropriate to the collection and the patient’s condition.

The operative note should identify the collection as an abscess or hematoma and document its deep shoulder-region location and the incision and drainage performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. CMS payment for an assistant at surgery is statutorily restricted; co-surgeons and team surgery are 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 23030 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

23030 rates by state

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

How the 23030 rate is calculated

Each of 23030’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 23030

23030 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

23030 compared with similar codes

How to choose

23031Bursa drainage

Choose 23031 when the infected structure is a shoulder bursa; 23030 is for a deep shoulder-region abscess or hematoma outside that specific target.

23040Shoulder arthrotomy

23040 involves entry into the glenohumeral joint for exploration or drainage. 23030 targets a deep soft-tissue collection in the shoulder region.

10060Abscess drainage

10060 is for simple, superficial abscess drainage. 23030 is the shoulder-region code for a deep abscess or hematoma.

10061Abscess drainage

10061 addresses complicated or multiple superficial abscesses; it is not the deep shoulder-region drainage service described by 23030.

Codes related to 23030

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