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Billing code 23400: ScapulopexyMedicare rate & RVUs

Scapulopexy surgically repositions and fixes an elevated scapula, most often to correct congenital Sprengel deformity and improve shoulder position or motion.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $898.82 for 23400 nationally in a facility.

Medicare rate · 23400

Scapulopexy

Swap in your local Medicare rate.

Work RVUs
13.52
Total RVUs
26.91
Global days
090

National rate · 2026

$898.82

Facility setting, before claim adjustments.

See every locality for 23400 → · 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 23400 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 23400 covers

Scapulopexy repositions and stabilizes the scapula, commonly as part of surgical correction of congenital Sprengel deformity, in which one shoulder blade sits abnormally high. An orthopedic surgeon performs the operation in an operating room. The approach and fixation method depend on the deformity and the structures involved; the procedure is directed at the position of the scapula, not the rotator cuff or shoulder joint capsule.

Report 23400 when the operative work is scapular fixation or repositioning, supported by documentation of the deformity, the side treated, and the corrective fixation performed. The CMS global period is 90 days, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires 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 23400 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

23400 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$813.09
Alaska*Unavailable$1,104.06
ArizonaUnavailable$874.05
ArkansasUnavailable$802.55
AtlantaUnavailable$925.19
AustinUnavailable$909.06
BakersfieldUnavailable$903.32
Baltimore/Surr. CntysUnavailable$954.52
BeaumontUnavailable$860.40
BrazoriaUnavailable$878.04

23400 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

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View every state and territory as a table
23400 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 23400 rate is calculated

Each of 23400’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 · 23400

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.52Practice expense 10.50Malpractice 2.89

26.9100 adjusted RVUs×$33.4009 conversion factor=$898.82

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

Payment rules and modifiers for 23400

23400 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23400

Scapulopexy

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 · 23400

Scapulopexy

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

23400 without 50 · national facility

$898.82

Scapulopexy

23400-50 · Bilateral: 150%

$1,348.23

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

23400 compared with similar codes

Compare codes

23400 vs 23405 vs 23406 vs 23491: national Medicare rates

Swap in your local Medicare rate.

  • 23400
    Scapulopexy · 13.52 wRVU
    —
  • 23405
    Shoulder tenotomy · 8.33 wRVU
    —
  • 23406
    Tendon release · 10.73 wRVU
    —
  • 23491
    Scapular stabilization · 14.18 wRVU
    —

How to choose

23405Shoulder tenotomy
This code describes incision of a single tendon or muscle in the shoulder area. It is not the code for repositioning and fixing an elevated scapula.
23406Tendon release
This code describes incision of multiple tendons or muscles through the same incision. Choose 23400 when the operative objective is scapular fixation, not muscle or tendon incision alone.
23491Scapular stabilization
This code addresses reinforcement of shoulder bones. Scapulopexy instead corrects scapular position, commonly for Sprengel deformity.

Codes related to 23400

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

Codes related to 23400
CodeHow it relatesNational office range
Used instead
23395Muscle transferA single muscle transfer may address scapular dysfunction from a different cause, such as muscle paralysis.No office rate
23397Muscle transferMultiple muscle transfer is a different surgical approach to selected shoulder-girdle muscle dysfunction.No office rate

23400 billing questions

When is 23400 appropriate instead of a shoulder repair code?

Use 23400 for surgical fixation or repositioning of the scapula, such as correction of Sprengel deformity. Rotator cuff, biceps tendon, and shoulder capsule repairs describe different operative targets.

Does the 90-day global period include routine postoperative care?

Yes. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral scapulopexy reported?

CMS identifies the procedure as bilateral and pays reporting with modifier 50 at 150%. Documentation should establish that both sides were treated.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How does the multiple-procedure rule affect 23400?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

What operative details support reporting 23400?

Document the scapular deformity, side, and the repositioning and fixation performed. The record should make clear that the work corrects scapular position rather than repairing a tendon or shoulder joint structure.

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 23400PPRRVU2026_Oct_nonQPP.csv, line 2,195 (RVU26D)

Open CMS sourceHow we calculate rates

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