CPT code 23350: Shoulder injection2026 Medicare rate & RVUs
Reports contrast injection into the shoulder joint to support arthrography or enhanced CT or MRI, separately from the diagnostic imaging service.
Medicare pays $156.98 for 23350 nationally in the office and $42.09 in a hospital or facility. Local office rates run $138.43–$212.78.
Medicare rate · 23350
Shoulder injection
- Work RVUs
- 0.98
- Total RVUs
- 4.70
- Global days
- 000
National rate · 2026
$156.98
Office setting, before claim adjustments.
See every locality for 23350 →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.
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On this page 10 sections
What 23350 covers
This service places contrast material into the shoulder joint so imaging can show joint structures more clearly. It is commonly performed by a radiologist or other qualified clinician in an imaging department, using imaging guidance to direct the needle. The injection supports shoulder arthrography or CT or MRI performed with intra-articular contrast; it is not the same service as a therapeutic shoulder injection.
Report 23350 for the contrast injection, and report the imaging examination separately when performed. Documentation should identify the shoulder and side, the diagnostic purpose, and the contrast administration. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to a 50% reduction. The 0-day global period includes same-day preoperative and postoperative care. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are 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 23350 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$138.43 to $212.78
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $140.52 | $39.99 |
| Alaska | $179.88 | $57.51 |
| Arizona | $152.79 | $41.46 |
| Arkansas | $138.43 | $39.73 |
| Atlanta, GA | $159.63 | $42.89 |
| Austin, TX | $163.74 | $42.18 |
| Bakersfield, CA | $168.07 | $42.14 |
| Baltimore area, MD | $167.07 | $43.78 |
| Beaumont, TX | $145.86 | $41.30 |
| Brazoria, TX | $155.49 | $41.63 |
| Chicago, IL | $161.71 | $46.24 |
| Chico, CA | $167.79 | $41.86 |
| Colorado | $164.48 | $42.23 |
| Connecticut | $167.61 | $43.86 |
| Dallas, TX | $156.37 | $41.93 |
| Delaware | $155.39 | $41.87 |
| Detroit, MI | $154.80 | $43.93 |
| East St. Louis, IL | $150.33 | $44.63 |
| El Centro, CA | $167.80 | $41.87 |
| Fort Lauderdale, FL | $160.99 | $44.60 |
| Fort Worth, TX | $155.19 | $41.90 |
| Fresno, CA | $167.79 | $41.86 |
| Galveston, TX | $155.88 | $41.79 |
| Hanford, CA | $167.79 | $41.86 |
| Hawaii, Guam, HI | $172.33 | $41.69 |
| Houston, TX | $157.53 | $43.43 |
| Idaho | $145.70 | $39.99 |
| Indiana | $146.59 | $40.08 |
| Iowa | $144.87 | $39.73 |
| Kansas | $143.85 | $39.98 |
| Kentucky | $143.27 | $41.13 |
| King County, WA | $185.59 | $44.61 |
| Los Angeles, CA | $179.50 | $43.58 |
| Madera, CA | $167.79 | $41.86 |
| Manhattan, NY | $180.48 | $46.97 |
| Marin County, CA | $208.18 | $46.17 |
| Merced, CA | $167.79 | $41.86 |
| Metropolitan Boston, MA | $181.52 | $44.33 |
| Metropolitan Kansas City, MO | $149.52 | $41.63 |
| Metropolitan Philadelphia, PA | $163.12 | $43.51 |
| Metropolitan St. Louis, MO | $151.17 | $41.79 |
| Miami, FL | $166.55 | $46.94 |
| Minnesota | $158.38 | $40.15 |
| Mississippi | $139.35 | $40.42 |
| Modesto, CA | $167.79 | $41.86 |
| Montana | $156.98 | $42.08 |
| Napa, CA | $196.12 | $44.69 |
| Nebraska | $145.78 | $39.73 |
| Nevada | $156.60 | $41.59 |
| New Hampshire | $161.58 | $41.97 |
| New Mexico | $147.53 | $42.16 |
| New Orleans, LA | $150.24 | $42.12 |
| North Carolina | $147.78 | $40.57 |
| North Dakota | $155.20 | $40.30 |
| Northern New Jersey | $178.65 | $45.37 |
| NYC suburbs and Long Island, NY | $184.57 | $47.96 |
| Ohio | $146.46 | $41.56 |
| Oklahoma | $143.34 | $40.74 |
| Oxnard, CA | $178.83 | $43.02 |
| Portland, OR | $170.20 | $42.54 |
| Poughkeepsie and northern NYC suburbs, NY | $170.61 | $44.79 |
| Puerto Rico | $158.27 | $42.11 |
| Queens, NY | $182.47 | $46.66 |
| Redding, CA | $167.79 | $41.86 |
| Rest of California | $167.79 | $41.86 |
| Rest of Florida | $153.16 | $43.32 |
| Rest of Georgia | $144.47 | $41.98 |
| Rest of Illinois | $148.13 | $43.23 |
| Rest of Louisiana | $142.91 | $41.23 |
| Rest of Maine | $146.15 | $40.44 |
| Rest of Maryland | $158.52 | $42.24 |
| Rest of Massachusetts | $163.32 | $42.33 |
| Rest of Michigan | $146.82 | $41.92 |
| Rest of Missouri | $140.17 | $41.13 |
| Rest of New Jersey | $169.74 | $44.27 |
| Rest of New York | $150.03 | $40.88 |
| Rest of Oregon | $155.61 | $41.17 |
| Rest of Pennsylvania | $146.88 | $41.40 |
| Rest of Texas | $150.51 | $41.47 |
| Rest of Washington | $163.12 | $42.13 |
| Rhode Island | $161.28 | $42.59 |
| Riverside, CA | $168.77 | $42.84 |
| Sacramento, CA | $176.53 | $42.90 |
| Salinas, CA | $175.88 | $42.71 |
| San Benito County, CA | $212.78 | $47.10 |
| San Diego, CA | $180.35 | $42.93 |
| San Francisco, CA | $208.08 | $46.07 |
| San Luis Obispo, CA | $173.00 | $42.13 |
| Santa Clara County, CA | $212.36 | $46.68 |
| Santa Cruz, CA | $182.34 | $42.74 |
| Santa Maria, CA | $176.63 | $42.66 |
| Santa Rosa, CA | $184.22 | $43.12 |
| South Carolina | $147.32 | $41.15 |
| South Dakota | $154.99 | $40.09 |
| Southern Maine, ME | $154.78 | $40.92 |
| Stockton, CA | $167.79 | $41.86 |
| Suburban Chicago, IL | $162.81 | $44.81 |
| Tennessee | $144.56 | $40.12 |
| Utah | $149.40 | $41.40 |
| Vallejo, CA | $195.98 | $44.54 |
| Vermont | $154.29 | $40.54 |
| Virgin Islands, VI | $158.27 | $42.11 |
| Virginia | $154.04 | $41.09 |
| Visalia, CA | $167.79 | $41.86 |
| Washington, DC area | $180.67 | $45.32 |
| West Virginia | $142.40 | $42.55 |
| Wisconsin | $149.81 | $39.74 |
| Wyoming | $156.20 | $41.30 |
| Yuba City, CA | $167.79 | $41.86 |
23350 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$138.43
$190.29
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $179.88 | 1 |
| AL | $140.52 | 1 |
| AR | $138.43 | 1 |
| AZ | $152.79 | 1 |
| CA | $167.79–$212.78 | 29 |
| CO | $164.48 | 1 |
| CT | $167.61 | 1 |
| DC | $180.67 | 1 |
| DE | $155.39 | 1 |
| FL | $153.16–$166.55 | 3 |
| GA | $144.47–$159.63 | 2 |
| GU | $172.33 | 1 |
| HI | $172.33 | 1 |
| IA | $144.87 | 1 |
| ID | $145.70 | 1 |
| IL | $148.13–$162.81 | 4 |
| IN | $146.59 | 1 |
| KS | $143.85 | 1 |
| KY | $143.27 | 1 |
| LA | $142.91–$150.24 | 2 |
| MA | $163.32–$181.52 | 2 |
| MD | $158.52–$180.67 | 3 |
| ME | $146.15–$154.78 | 2 |
| MI | $146.82–$154.80 | 2 |
| MN | $158.38 | 1 |
| MO | $140.17–$151.17 | 3 |
| MS | $139.35 | 1 |
| MT | $156.98 | 1 |
| NC | $147.78 | 1 |
| ND | $155.20 | 1 |
| NE | $145.78 | 1 |
| NH | $161.58 | 1 |
| NJ | $169.74–$178.65 | 2 |
| NM | $147.53 | 1 |
| NV | $156.60 | 1 |
| NY | $150.03–$184.57 | 5 |
| OH | $146.46 | 1 |
| OK | $143.34 | 1 |
| OR | $155.61–$170.20 | 2 |
| PA | $146.88–$163.12 | 2 |
| PR | $158.27 | 1 |
| RI | $161.28 | 1 |
| SC | $147.32 | 1 |
| SD | $154.99 | 1 |
| TN | $144.56 | 1 |
| TX | $145.86–$163.74 | 8 |
| UT | $149.40 | 1 |
| VA | $154.04–$180.67 | 2 |
| VI | $158.27 | 1 |
| VT | $154.29 | 1 |
| WA | $163.12–$185.59 | 2 |
| WI | $149.81 | 1 |
| WV | $142.40 | 1 |
| WY | $156.20 | 1 |
How the 23350 rate is calculated
Each of 23350’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 · 23350
RVUs × geographic indexes × conversion factor
Work0.98
0.98 RVUs× 1.000 GPCI
Practice expense3.63
3.63 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
4.7000
Conversion factor
$33.4009
Medicare rate
$156.98
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23350
The CMS indicators that decide how 23350 is paid alongside other services.
CMS payment indicators · 23350
Shoulder injection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
23350 without 50 · national office
$156.98
Shoulder injection
23350-50 · Bilateral: 150%
$235.47
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).
23350 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20610Joint injection
- 20610 reports aspiration or injection of a major joint for a therapeutic or diagnostic purpose other than arthrographic contrast delivery. Use 23350 for shoulder-joint contrast injection supporting imaging.
- 73040Shoulder arthrography
- 73040 reports the shoulder arthrography imaging examination, while 23350 reports injecting contrast into the joint. They may be reported together when both services are performed.
- 73222Joint MRI
- 73222 reports MRI of an upper-extremity joint with contrast; 23350 reports the shoulder-joint contrast injection that may support the MRI.
23350 billing questions
How is 23350 different from a therapeutic shoulder injection?
Use 23350 when contrast is injected into the shoulder joint for diagnostic imaging. A therapeutic injection or aspiration of a major joint is reported with a different code, such as 20610, when that service is performed.
Is the imaging examination included in 23350?
No. 23350 reports the contrast injection; report the shoulder arthrography, CT, or MRI examination separately when performed.
How should bilateral shoulder injections be reported?
Report the bilateral procedure with modifier 50. CMS pays the bilateral procedure at 150%.
What documentation supports reporting 23350?
Document the shoulder and side, the diagnostic imaging purpose, and that contrast was administered into the joint. The record should distinguish this diagnostic injection from a therapeutic injection.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the 0-day global period.
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
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