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Billing code 23415: Shoulder decompressionMedicare rate & RVUs

Reports open release of the shoulder’s coracoacromial ligament, with or without acromioplasty, during surgery for subacromial impingement.

CMS RVU26DEffective Oct 1, 2026109 payment localities257 Medicare services in 2024

Medicare pays $658.33 for 23415 nationally in a facility.

Medicare rate · 23415

Shoulder decompression

Swap in your local Medicare rate.

Work RVUs
9
Total RVUs
19.71
Global days
090

National rate · 2026

$658.33

Facility setting, before claim adjustments.

See every locality for 23415 → · 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 23415 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 23415 covers

The surgeon releases the coracoacromial ligament, which spans the coracoid process and acromion, to increase clearance in the subacromial space. The procedure may include reshaping the acromion. An orthopedic surgeon typically performs it through an open approach during surgery for shoulder impingement, sometimes in the same session as rotator cuff repair.

Report 23415 when the operative work includes an open coracoacromial ligament release; acromioplasty may be performed with it. The operative report should identify the ligament release and any acromial work, rather than relying on an impingement diagnosis alone. 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 one session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral work reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is restricted; 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 23415 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

23415 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$594.52
Alaska*Unavailable$800.13
ArizonaUnavailable$640.26
ArkansasUnavailable$586.64
AtlantaUnavailable$676.39
AustinUnavailable$669.05
BakersfieldUnavailable$668.29
Baltimore/Surr. CntysUnavailable$699.39
BeaumontUnavailable$627.31
BrazoriaUnavailable$644.48

23415 rates by state

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

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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
23415 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 23415 rate is calculated

Each of 23415’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 · 23415

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.00Practice expense 8.86Malpractice 1.85

19.7100 adjusted RVUs×$33.4009 conversion factor=$658.33

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

Payment rules and modifiers for 23415

23415 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23415

Shoulder decompression

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)1Not paid (statutory restriction).
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 · 23415

Shoulder decompression

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

23415 without 50 · national facility

$658.33

Shoulder decompression

23415-50 · Bilateral: 150%

$987.50

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

23415 compared with similar codes

Compare codes

23415 vs 29826 vs 23412 vs 23410: national Medicare rates

Swap in your local Medicare rate.

  • 23415
    Shoulder decompression · 9 wRVU
    —
  • 29826
    Shoulder decompression · 2.93 wRVU
    —
  • 23412
    Rotator cuff repair · 11.63 wRVU
    —
  • 23410
    Rotator cuff repair · 11.11 wRVU
    —

How to choose

29826Shoulder decompression
This code describes arthroscopic subacromial decompression. Use 23415 for the open ligament-release procedure.
23412Rotator cuff repair
23412 reports repair of a chronic rotator cuff tear; 23415 reports open coracoacromial ligament release, with or without acromioplasty.
23410Rotator cuff repair
23410 reports repair of an acute rotator cuff tear. It does not identify the ligament-release and acromial work described by 23415.

Codes related to 23415

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

Codes related to 23415
CodeHow it relatesNational office range
Used instead
29826Shoulder decompressionArthroscopic subacromial decompression; use for the arthroscopic approach rather than open release.No office rate
Often billed with
23412Rotator cuff repairChronic rotator cuff repair may accompany ligament release when both distinct services are performed.No office rate
23410Rotator cuff repairAcute rotator cuff repair may accompany ligament release when both distinct services are performed.No office rate

23415 billing questions

Does 23415 include acromioplasty?

Yes. The code covers coracoacromial ligament release with or without acromioplasty, so acromial reshaping performed as part of that service is included.

Can 23415 be reported with a rotator cuff repair?

The codes describe different work: ligament release and acromial work versus tendon repair. Report both only when both services were performed and the applicable coding edits permit separate reporting.

How does 23415 differ from 29826?

23415 describes the open approach. Code 29826 describes arthroscopic subacromial decompression, so the operative approach distinguishes the codes.

What documentation supports 23415?

The operative report should identify the open release of the coracoacromial ligament and describe any acromioplasty performed. A diagnosis of shoulder impingement alone does not establish that the procedure was done.

What are the assistant and co-surgeon payment rules?

CMS does not pay an assistant at surgery for this code. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

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 23415PPRRVU2026_Oct_nonQPP.csv, line 2,200 (RVU26D)

Open CMS sourceHow we calculate rates

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