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Billing code 23145: Bone lesion removalMedicare rate & RVUs

Reports operative curettage or excision of a benign bone cyst or tumor in the scapula when the defect is reconstructed with the patient’s own bone.

CMS RVU26DEffective Oct 1, 2026109 payment localities28 Medicare services in 2024

Medicare pays $657.00 for 23145 nationally in a facility.

Medicare rate · 23145

Bone lesion removal

Swap in your local Medicare rate.

Work RVUs
9.17
Total RVUs
19.67
Global days
090

National rate · 2026

$657.00

Facility setting, before claim adjustments.

See every locality for 23145 → · 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 23145 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 23145 covers

An orthopedic surgeon, often an orthopedic oncologist, uses this service to remove or curette a benign cystic or tumorous lesion in the scapula and fill the resulting defect with autologous bone graft. The work includes obtaining the patient’s graft as part of the procedure. It is a surgical treatment of a scapular lesion, not simply an arthrotomy for joint inspection or biopsy.

Report the code when the operative record supports the scapular site, lesion removal by curettage or excision, and use of the patient’s own bone graft. The 90-day global period includes 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 are subject to the standard 50% reduction. 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 23145 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

23145 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$593.03
Alaska*Unavailable$799.46
ArizonaUnavailable$638.76
ArkansasUnavailable$585.14
AtlantaUnavailable$675.58
AustinUnavailable$666.75
BakersfieldUnavailable$664.76
Baltimore/Surr. CntysUnavailable$698.18
BeaumontUnavailable$626.67
BrazoriaUnavailable$642.55

23145 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
23145 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 23145 rate is calculated

Each of 23145’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 · 23145

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.17Practice expense 8.55Malpractice 1.95

19.6700 adjusted RVUs×$33.4009 conversion factor=$657.00

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

Payment rules and modifiers for 23145

23145 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23145

Bone lesion removal

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 · 23145

Bone lesion removal

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

23145 without 50 · national facility

$657.00

Bone lesion removal

23145-50 · Bilateral: 150%

$985.50

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

23145 compared with similar codes

Compare codes

23145 vs 23146 vs 23140 vs 23150: national Medicare rates

Swap in your local Medicare rate.

  • 23145
    Bone lesion removal · 9.17 wRVU
    —
  • 23146
    Bone lesion removal · 7.88 wRVU
    —
  • 23140
    Bone lesion removal · 6.94 wRVU
    —
  • 23150
    Bone lesion removal · 8.69 wRVU
    —

How to choose

23146Bone lesion removal
The operative site and lesion treatment are comparable, but 23146 is the allograft option. Code 23145 describes reconstruction with the patient’s own bone.
23140Bone lesion removal
This neighboring lesion-removal code concerns the clavicle. Use 23145 when the treated lesion is in the scapula and autograft is used.
23150Bone lesion removal
This code concerns a benign lesion of the proximal humerus rather than the scapula. Select by the documented bone site.

Codes related to 23145

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

Codes related to 23145
CodeHow it relatesNational office range
Same family
23146Bone lesion removalScapular lesion removal using an allograft rather than the patient’s own bone.No office rate
23140Bone lesion removalComparable benign bone lesion removal involving the clavicle.No office rate
23150Bone lesion removalComparable benign bone lesion removal involving the proximal humerus.No office rate

23145 billing questions

When is 23145 different from 23146?

Both concern benign bone lesions of the scapula, but 23145 involves the patient’s own bone graft. Use 23146 for the allograft approach.

Can the graft-harvesting work be reported separately?

The autograft service includes obtaining the patient’s bone for the reconstruction. Do not separately report graft harvesting as though it were outside this procedure.

What documentation supports this code?

Document the scapular lesion, its removal by excision or curettage, and reconstruction with autologous bone graft. The operative note should make the graft type clear.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The code’s global package applies to care related to this operation.

Can modifier 50 be used for bilateral work?

CMS identifies this as a bilateral procedure; when reported with modifier 50, payment is at 150%. The record should support treatment on both sides.

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 23145PPRRVU2026_Oct_nonQPP.csv, line 2,172 (RVU26D)

Open CMS sourceHow we calculate rates

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