Billing code 23200: Clavicle tumor resectionMedicare rate & RVUs

Medicare pays $1,365.43 for 23200 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 23200 covers

This service involves extensive surgical removal of a tumor involving the clavicle, rather than a limited excision or curettage. It is typically performed by an orthopedic oncologist in an operating room, often in a hospital setting, for a tumor whose extent and surgical plan call for radical resection. The operative approach and structures removed depend on the tumor’s location and extent.

Select the code based on the radical nature of the tumor resection and the clavicular site. The operative report should identify the tumor, its relationship to the clavicle, and the extent of resection; imaging and pathology records can support the clinical picture. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others 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 23200 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

23200 rates by state

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

How the 23200 rate is calculated

Each of 23200’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 23200

23200 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

23200 compared with similar codes

How to choose

23140Bone lesion removal

This code describes excision or curettage of a clavicular bone cyst or benign tumor. Code 23200 describes radical tumor resection, not limited lesion treatment.

23120Clavicle resection

This code describes partial clavicle removal. Use 23200 when the operation is a radical resection for a tumor, rather than a partial claviculectomy.

23210Tumor resection

Both are radical tumor resection codes; 23210 applies when the tumor involves the scapula, while 23200 applies to the clavicle.

23220Tumor resection

Both are radical tumor resection codes; 23220 applies when the tumor involves the proximal humerus, while 23200 applies to the clavicle.

Codes related to 23200

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