Billing code 23460: Shoulder stabilizationMedicare rate & RVUs

Reported for operative stabilization of recurrent anterior shoulder instability when the surgeon adds a bone block to reinforce the glenoid.

CMS RVU26DEffective Oct 1, 2026109 payment localities33 Medicare services in 2024

Medicare pays $1,000.69 for 23460 nationally in a facility.

Medicare rate · 23460

Shoulder stabilization

Swap in your local Medicare rate.

Work RVUs
15.42
Total RVUs
29.96
Global days
090

National rate · 2026

$1,000.69

Facility setting, before claim adjustments.

See every locality for 23460 → · 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 23460 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 23460 covers

An orthopedic surgeon performs this stabilization for recurrent anterior shoulder dislocation or instability when a bone block is used to support the front of the glenoid. The added bone provides a structural buttress, while the capsular repair addresses the shoulder’s soft-tissue restraint. This procedure is typically performed in an operating room, such as a hospital or ambulatory surgery center, rather than an office setting.

Report the code when the operative report supports anterior capsular stabilization with a bone block; a soft-tissue repair alone or a coracoid transfer represents a different procedure. Documentation should identify the instability, the bone-block work, and the structures repaired. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 applies to bilateral procedures, paid at 150%. An assistant at surgery may be paid; 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 23460 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

23460 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$906.13
Alaska*Unavailable$1,233.47
ArizonaUnavailable$973.26
ArkansasUnavailable$894.53
AtlantaUnavailable$1,030.27
AustinUnavailable$1,011.05
BakersfieldUnavailable$1,003.75
Baltimore/Surr. CntysUnavailable$1,062.35
BeaumontUnavailable$959.06
BrazoriaUnavailable$977.32

23460 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.

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23460 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 23460 rate is calculated

Each of 23460’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 · 23460

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 15.42Practice expense 11.26Malpractice 3.28

29.9600 adjusted RVUs×$33.4009 conversion factor=$1,000.69

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

Payment rules and modifiers for 23460

23460 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23460

Shoulder stabilization

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 · 23460

Shoulder stabilization

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

23460 without 50 · national facility

$1,000.69

Shoulder stabilization

23460-50 · Bilateral: 150%

$1,501.04

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

23460 compared with similar codes

Compare codes

23460 vs 23450 vs 23455 vs 23462: national Medicare rates

Swap in your local Medicare rate.

  • 23460
    Shoulder stabilization · 15.42 wRVU
    —
  • 23450
    Shoulder stabilization · 13.36 wRVU
    —
  • 23455
    Shoulder stabilization · 14.3 wRVU
    —
  • 23462
    Shoulder stabilization · 15.33 wRVU
    —

How to choose

23450Shoulder stabilization
23450 describes anterior capsular stabilization without a bone block. Choose 23460 when the operative work includes the bone-block component.
23455Shoulder stabilization
23455 includes anterior labral repair, as in a Bankart-type repair. This code is distinguished by use of a bone block for anterior stabilization.
23462Shoulder stabilization
23462 describes anterior stabilization using transfer of the coracoid process. This code is for stabilization with a bone block rather than that transfer.

23460 billing questions

How is this code distinguished from 23455?

This code represents anterior stabilization that includes a bone block. Code 23455 is used for anterior capsular repair with labral repair, such as a Bankart-type procedure, without the bone-block distinction.

How is this different from a coracoid transfer?

Use this code when the documented stabilization includes a bone block rather than transfer of the coracoid process. The coracoid-transfer procedure is reported with 23462.

What should the operative report document?

Document the recurrent anterior instability, the bone block placed to support the glenoid, and the capsular repair or stabilization performed.

How does the 90-day global period affect postoperative billing?

The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are part of the surgical episode.

Can this procedure be reported bilaterally or with another procedure?

For bilateral performance, modifier 50 is paid at 150%. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%; an assistant may be paid, while co-surgeon payment requires supporting documentation.

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 23460PPRRVU2026_Oct_nonQPP.csv, line 2,206 (RVU26D)

Open CMS sourceHow we calculate rates

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