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Billing code 23155: Bone lesion excisionMedicare rate & RVUs

Report this operation when a surgeon removes or curettes a benign bone lesion in the humerus and fills the resulting defect with the patient’s own bone.

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

Medicare pays $748.51 for 23155 nationally in a facility.

Medicare rate · 23155

Bone lesion excision

Swap in your local Medicare rate.

Work RVUs
10.59
Total RVUs
22.41
Global days
090

National rate · 2026

$748.51

Facility setting, before claim adjustments.

See every locality for 23155 → · 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 23155 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 23155 covers

An orthopedic surgeon exposes the humerus, removes or curettes a bone cyst or benign tumor, and uses the patient’s own bone graft to fill the defect. The service is generally performed in an operating room, including a hospital outpatient department or ambulatory surgery center. The autograft is the distinguishing feature; a similar humeral lesion procedure without graft or with donor bone is coded differently.

Select this code when the operative report supports the humeral site, lesion removal or curettage, and use of autograft. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 applies to bilateral procedures, paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation. 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 23155 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

23155 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$675.94
Alaska*Unavailable$912.41
ArizonaUnavailable$727.78
ArkansasUnavailable$667.00
AtlantaUnavailable$769.80
AustinUnavailable$759.19
BakersfieldUnavailable$756.54
Baltimore/Surr. CntysUnavailable$795.32
BeaumontUnavailable$714.41
BrazoriaUnavailable$731.93

23155 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
23155 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 23155 rate is calculated

Each of 23155’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 · 23155

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.59Practice expense 9.57Malpractice 2.25

22.4100 adjusted RVUs×$33.4009 conversion factor=$748.51

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

Payment rules and modifiers for 23155

23155 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23155

Bone lesion excision

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 · 23155

Bone lesion excision

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

23155 without 50 · national facility

$748.51

Bone lesion excision

23155-50 · Bilateral: 150%

$1,122.77

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

23155 compared with similar codes

Compare codes

23155 vs 23150 vs 23156 vs 23184: national Medicare rates

Swap in your local Medicare rate.

  • 23155
    Bone lesion excision · 10.59 wRVU
    —
  • 23150
    Bone lesion removal · 8.69 wRVU
    —
  • 23156
    Bone lesion surgery · 8.88 wRVU
    —
  • 23184
    Bone excision · 9.65 wRVU
    —

How to choose

23150Bone lesion removal
Choose 23150 for humeral lesion removal or curettage without graft. Choose 23155 when the defect is filled with autograft.
23156Bone lesion surgery
Both address a humeral bone lesion, but 23156 is the allograft option; 23155 identifies use of the patient’s own bone.
23184Bone excision
23184 describes partial excision of proximal humerus. It is distinct from curettage or excision of a bone cyst or benign tumor with autograft.

Codes related to 23155

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

Codes related to 23155
CodeHow it relatesNational office range
Same family
23150Bone lesion removalHumeral lesion removal or curettage without graft.No office rate
23156Bone lesion surgeryHumeral lesion removal or curettage using allograft.No office rate
Used instead
23140Bone lesion removalRelated bone-lesion procedure for the clavicle rather than the humerus.No office rate
23145Bone lesion removalAnother clavicular bone-lesion procedure, selected for the clavicle site.No office rate

23155 billing questions

How is this different from 23150?

23155 describes humeral lesion removal or curettage with autograft. Use 23150 when the procedure is performed without a graft.

When would 23156 be used instead?

23156 is the related humeral lesion procedure when allograft is used. The operative report should identify the graft source.

Is the autograft part of this code?

Yes. Autograft use is the feature that distinguishes this code from the no-graft and allograft options in the humeral lesion group.

What documentation supports reporting 23155?

Document the humeral location, the bone cyst or benign tumor treated, the removal or curettage performed, and use of autograft to fill the defect.

How are bilateral cases and additional procedures handled?

Modifier 50 applies to bilateral procedures, with payment at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction.

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.

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 23155PPRRVU2026_Oct_nonQPP.csv, line 2,175 (RVU26D)

Open CMS sourceHow we calculate rates

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