FeeBase
Log inGet started
Menu

Billing code 23406: Tendon releaseMedicare rate & RVUs

Reports operative release of multiple tendons in the shoulder region, such as for a contracture when several tendon structures require division.

CMS RVU26DEffective Oct 1, 2026109 payment localities388 Medicare services in 2024

Medicare pays $674.03 for 23406 nationally in a facility.

Medicare rate · 23406

Tendon release

Swap in your local Medicare rate.

Work RVUs
10.73
Total RVUs
20.18
Global days
090

National rate · 2026

$674.03

Facility setting, before claim adjustments.

See every locality for 23406 → · 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 23406 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 23406 covers

Code 23406 describes an operation that divides or releases multiple tendons in the shoulder region. An orthopedic surgeon may perform it when a shoulder contracture or deformity requires release of several tendon structures. It is distinct from an operation that repairs a torn rotator cuff or secures a tendon to bone.

Select the code based on the operative report’s account of the shoulder-area tendons released; a release of one tendon points to the single-tendon sibling code. Documentation should identify the treated structures and the operative work performed. CMS assigns 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. The bilateral adjustment does not apply, and modifier 50 is inappropriate. CMS permits assistant-at-surgery payment; 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 23406 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

23406 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$619.30
Alaska*Unavailable$848.33
ArizonaUnavailable$658.66
ArkansasUnavailable$612.52
AtlantaUnavailable$689.30
AustinUnavailable$684.55
BakersfieldUnavailable$687.07
Baltimore/Surr. CntysUnavailable$710.91
BeaumontUnavailable$646.56
BrazoriaUnavailable$663.63

23406 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
23406 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 23406 rate is calculated

Each of 23406’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 · 23406

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.73Practice expense 7.97Malpractice 1.48

20.1800 adjusted RVUs×$33.4009 conversion factor=$674.03

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

Payment rules and modifiers for 23406

23406 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23406

Tendon release

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)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
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 · 23406

Tendon release

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 51 · payment effect

With and without the modifier

23406 without 51 · national facility

$674.03

Tendon release

23406-51 · Second procedure: 50%

$337.02

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

23406 compared with similar codes

Compare codes

23406 vs 23405 vs 23410 vs 23412 vs 23440: national Medicare rates

Swap in your local Medicare rate.

  • 23406
    Tendon release · 10.73 wRVU
    —
  • 23405
    Shoulder tenotomy · 8.33 wRVU
    —
  • 23410
    Rotator cuff repair · 11.11 wRVU
    —
  • 23412
    Rotator cuff repair · 11.63 wRVU
    —
  • 23440
    Biceps tenodesis · 10.37 wRVU
    —

How to choose

23405Shoulder tenotomy
Choose 23405 when one shoulder-area tendon is released; 23406 describes release of multiple tendons.
23410Rotator cuff repair
23410 represents repair of an acute rotator cuff tear, while 23406 represents release rather than repair.
23412Rotator cuff repair
23412 represents repair of a chronic rotator cuff tear; 23406 is for release of multiple shoulder-area tendons.
23440Biceps tenodesis
23440 is directed at the long-head biceps tendon; 23406 describes release of multiple tendons in the shoulder region.

Codes related to 23406

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

Codes related to 23406
CodeHow it relatesNational office range
Same family
23405Shoulder tenotomySibling code for release of one shoulder-area tendon rather than multiple tendons.No office rate
Used instead
23430Biceps surgeryTenodesis is used when the long-head biceps tendon is secured to bone.No office rate
23440Biceps tenodesisUsed for a procedure directed specifically at the long-head biceps tendon.No office rate

23406 billing questions

How does 23406 differ from 23405?

23406 is for release of multiple shoulder-area tendons. Use 23405 when the operative work releases a single tendon.

Does 23406 describe rotator cuff repair?

No. It describes tendon release or division, not repair of a torn rotator cuff. The operative report should support the work actually performed.

Should modifier 50 be appended for both shoulders?

No. CMS identifies the bilateral adjustment as inapplicable to this code and modifier 50 as inappropriate.

What postoperative care is included?

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

Can an assistant surgeon be reported?

CMS permits assistant-at-surgery payment for 23406. Co-surgeons and team surgery are not permitted.

How are other procedures in the same session paid?

CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full, and other procedures are paid at 50%.

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 23406PPRRVU2026_Oct_nonQPP.csv, line 2,197 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 23406 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 23406 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →