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Billing code 23078: Shoulder tumor resectionMedicare rate & RVUs

Reports radical removal of a shoulder-area soft-tissue tumor measuring at least 5 cm, typically when oncologic resection requires removal beyond a simple local excision.

CMS RVU26DEffective Oct 1, 2026109 payment localities263 Medicare services in 2024

Medicare pays $1,325.68 for 23078 nationally in a facility.

Medicare rate · 23078

Shoulder tumor resection

Swap in your local Medicare rate.

Work RVUs
21.99
Total RVUs
39.69
Global days
090

National rate · 2026

$1,325.68

Facility setting, before claim adjustments.

See every locality for 23078 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 23078 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 23078 covers

This code describes radical resection of a soft-tissue tumor in the shoulder area measuring 5 cm or larger. It is commonly used for oncologic operations, such as resection of a suspected or confirmed soft-tissue sarcoma, and is typically performed by an orthopedic oncologic or other qualified surgeon in an operating room. The operative work is more extensive than a routine local excision; the surgeon documents the tumor’s location, size, depth, and the extent of tissue removed.

Select this code when the procedure is a radical resection and the tumor meets the size threshold, rather than a deep-tumor excision or a biopsy. The operative report should support the shoulder-area site, measured size, and radical nature of the removal. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 23078 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

23078 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,199.97
Alaska*Unavailable$1,645.17
ArizonaUnavailable$1,288.41
ArkansasUnavailable$1,184.64
AtlantaUnavailable$1,368.36
AustinUnavailable$1,332.60
BakersfieldUnavailable$1,314.74
Baltimore/Surr. CntysUnavailable$1,408.09
BeaumontUnavailable$1,275.66
BrazoriaUnavailable$1,290.86

23078 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
23078 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 23078 rate is calculated

Each of 23078’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 · 23078

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.99Practice expense 12.68Malpractice 5.02

39.6900 adjusted RVUs×$33.4009 conversion factor=$1,325.68

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 23078

23078 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23078

Shoulder tumor resection

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 23078

Shoulder tumor resection

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

23078 without 50 · national facility

$1,325.68

Shoulder tumor resection

23078-50 · Bilateral: 150%

$1,988.52

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).

When to use modifier 50

23078 compared with similar codes

Compare codes

23078 vs 23077 vs 23073 vs 23066: national Medicare rates

Swap in your local Medicare rate.

  • 23078
    Shoulder tumor resection · 21.99 wRVU
    —
  • 23077
    Shoulder tumor surgery · 17.22 wRVU
    —
  • 23073
    Shoulder tumor excision · 9.88 wRVU
    —
  • 23066
    Shoulder biopsy · 4.19 wRVU
    $625.60

How to choose

23077Shoulder tumor surgery
Use 23077 for radical resection of a shoulder-area tumor smaller than 5 cm; 23078 applies at 5 cm or larger.
23073Shoulder tumor excision
Use 23073 for excision of a deep shoulder tumor measuring 5 cm or larger. Use 23078 when the documented operation is a radical resection.
23066Shoulder biopsy
23066 reports biopsy of shoulder tissue for diagnostic sampling. It does not describe definitive radical tumor resection.

Codes related to 23078

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

Codes related to 23078
CodeHow it relatesNational office range
Same family
23077Shoulder tumor surgeryRadical resection of a shoulder-area tumor smaller than 5 cm.No office rate
Used instead
23073Shoulder tumor excisionDeep shoulder tumor excision for tumors measuring 5 cm or larger.No office rate
23076Shoulder tumor excisionDeep shoulder tumor excision for tumors smaller than 5 cm.No office rate
23066Shoulder biopsyShoulder tissue biopsy when tissue sampling, rather than radical tumor removal, is performed.$546.55–$827.81

23078 billing questions

When should I choose 23078 instead of 23077?

Both describe radical resection of a shoulder-area tumor, but 23078 is for a tumor measuring 5 cm or larger. Code 23077 is for a tumor smaller than 5 cm.

How is 23078 different from 23073?

23078 represents radical resection of a tumor measuring at least 5 cm. Code 23073 describes excision of a deep shoulder tumor of that size, rather than radical resection.

What documentation supports reporting 23078?

The operative report should identify the shoulder-area tumor, document its size as at least 5 cm, and describe the extent of the radical resection.

Does the 90-day global period include postoperative visits?

Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.

How is bilateral reporting handled?

When the procedure is performed bilaterally and reported with modifier 50, CMS pays 150% under the stated bilateral rule.

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
RVUs for 23078PPRRVU2026_Oct_nonQPP.csv, line 2,162 (RVU26D)

Open CMS sourceHow we calculate rates

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