Billing code 23190: Bone removalMedicare rate & RVUs

Medicare pays $548.44 for 23190 nationally in a facility.

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

What 23190 covers

An orthopedic surgeon removes a limited portion of the scapula to address a bony prominence or contour that is causing symptoms. A familiar clinical situation is partial removal of a prominent scapular edge in a patient with painful snapping over the shoulder blade. The work is performed as an operation, typically in a facility setting, and the operative report should identify the portion of scapula removed and the reason for the bone resection.

Select this code when the procedure is a partial ostectomy, rather than removal of a defined bone lesion, resection of infected or necrotic bone, or removal of the acromion. The operative note should describe the bone removed, the extent of resection, and the clinical indication so the service can be distinguished from those procedures. CMS 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 the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons are paid only with 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 23190 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

23190 rates by state

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

How the 23190 rate is calculated

Each of 23190’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 23190

23190 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

23190 compared with similar codes

How to choose

23182Bone excision

This code describes partial scapular ostectomy for a symptomatic bony prominence or contour. Code 23182 is for partial bone excision, including procedures directed at infected bone.

23172Sequestrectomy

Use 23172 when the operation removes a sequestrum from the scapula. This code describes partial removal of scapular bone for another operative purpose.

23140Bone lesion removal

Use 23140 when excision or curettage targets a scapular bone cyst or benign tumor. This code is for partial ostectomy rather than lesion-specific removal.

Codes related to 23190

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