No office rate
Use 23920 for the shoulder disarticulation itself. Use 23921 when the open wound from that amputation is closed in a later operative session.
On this page
CMS RVU26D · Effective 2026-10-01
23921 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$453.35
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Upper-extremity surgery
About 23921: Secondary closure after shoulder disarticulation
Reports delayed surgical closure of an open shoulder-disarticulation wound when the stump is closed in a separate operative session.
This service closes a shoulder-disarticulation wound that was left open and requires closure in a later operative session. The surgeon prepares the existing amputation wound and brings the tissue together to complete stump closure. It is distinct from performing the shoulder disarticulation itself. The procedure may arise after an amputation wound was intentionally left open or could not be closed at the initial operation; the operative report should establish that this is secondary closure of the shoulder-disarticulation site.
Report this code for the delayed closure, not for the initial disarticulation or routine wound care. The code has 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 other procedures are subject to the standard 50% reduction. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 23921
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.58 · 41%
- Practice expense (office) RVU6.97 · 51%
- Malpractice RVU1.20 · 9%
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.
23921 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
23900 describes a more extensive amputation involving the shoulder girdle. It is not the delayed closure code for a shoulder-disarticulation stump.
No office rate
13160 describes extensive or complicated secondary closure of a surgical wound or dehiscence. Use 23921 when the closure is specifically for a shoulder-disarticulation wound.
The same code, a different location
How does Delaware compare?
23921 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 23921
Office
Unavailable
Facility
$412.77
No comparable office rate is available.
Arkansas
Arkansas · 23921
Office
Unavailable
Facility
$407.00
No comparable office rate is available.
Arizona
Arizona · 23921
Office
Unavailable
Facility
$446.27
No comparable office rate is available.
Bakersfield
California · 23921
Office
Unavailable
Facility
$469.48
No comparable office rate is available.
Chico
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
El Centro
California · 23921
Office
Unavailable
Facility
$466.38
No comparable office rate is available.
Fresno
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
Hanford-Corcoran
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
Madera
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
Merced
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
Modesto
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
Napa
California · 23921
Office
Unavailable
Facility
$525.32
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 23921
Office
Unavailable
Facility
$491.74
No comparable office rate is available.
Redding
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
Rest Of California
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 23921
Office
Unavailable
Facility
$479.07
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 23921
Office
Unavailable
Facility
$485.32
No comparable office rate is available.
Salinas
California · 23921
Office
Unavailable
Facility
$483.46
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 23921
Office
Unavailable
Facility
$492.13
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 23921
Office
Unavailable
Facility
$550.73
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 23921
Office
Unavailable
Facility
$549.37
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 23921
Office
Unavailable
Facility
$564.07
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 23921
Office
Unavailable
Facility
$558.49
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 23921
Office
Unavailable
Facility
$476.19
No comparable office rate is available.
Santa Cruz-Watsonville
California · 23921
Office
Unavailable
Facility
$494.63
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 23921
Office
Unavailable
Facility
$484.53
No comparable office rate is available.
Santa Rosa-Petaluma
California · 23921
Office
Unavailable
Facility
$499.34
No comparable office rate is available.
Stockton
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
Vallejo
California · 23921
Office
Unavailable
Facility
$523.35
No comparable office rate is available.
Visalia
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
Yuba City
California · 23921
Office
Unavailable
Facility
$466.18
No comparable office rate is available.
Colorado
Colorado · 23921
Office
Unavailable
Facility
$467.62
No comparable office rate is available.
Connecticut
Connecticut · 23921
Office
Unavailable
Facility
$489.33
No comparable office rate is available.
Fort Lauderdale
Florida · 23921
Office
Unavailable
Facility
$494.67
No comparable office rate is available.
Rest Of Florida
Florida · 23921
Office
Unavailable
Facility
$469.18
No comparable office rate is available.
Atlanta
Georgia · 23921
Office
Unavailable
Facility
$471.60
No comparable office rate is available.
Rest Of Georgia
Georgia · 23921
Office
Unavailable
Facility
$441.82
No comparable office rate is available.
Hawaii, Guam
Hawaii · 23921
Office
Unavailable
Facility
$474.28
No comparable office rate is available.
Iowa
Iowa · 23921
Office
Unavailable
Facility
$415.31
No comparable office rate is available.
Idaho
Idaho · 23921
Office
Unavailable
Facility
$419.52
No comparable office rate is available.
East St. Louis
Illinois · 23921
Office
Unavailable
Facility
$481.28
No comparable office rate is available.
Rest Of Illinois
Illinois · 23921
Office
Unavailable
Facility
$461.57
No comparable office rate is available.
Suburban Chicago
Illinois · 23921
Office
Unavailable
Facility
$497.80
No comparable office rate is available.
Indiana
Indiana · 23921
Office
Unavailable
Facility
$421.67
No comparable office rate is available.
Kansas
Kansas · 23921
Office
Unavailable
Facility
$417.03
No comparable office rate is available.
Kentucky
Kentucky · 23921
Office
Unavailable
Facility
$430.01
No comparable office rate is available.
New Orleans
Louisiana · 23921
Office
Unavailable
Facility
$450.98
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 23921
Office
Unavailable
Facility
$430.81
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 23921
Office
Unavailable
Facility
$507.66
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 23921
Office
Unavailable
Facility
$466.45
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 23921
Office
Unavailable
Facility
$488.74
No comparable office rate is available.
Rest Of Maryland
Maryland · 23921
Office
Unavailable
Facility
$460.63
No comparable office rate is available.
Rest Of Maine
Maine · 23921
Office
Unavailable
Facility
$425.49
No comparable office rate is available.
Southern Maine
Maine · 23921
Office
Unavailable
Facility
$442.38
No comparable office rate is available.
Detroit
Michigan · 23921
Office
Unavailable
Facility
$478.61
No comparable office rate is available.
Rest Of Michigan
Michigan · 23921
Office
Unavailable
Facility
$444.18
No comparable office rate is available.
Minnesota
Minnesota · 23921
Office
Unavailable
Facility
$437.80
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 23921
Office
Unavailable
Facility
$444.14
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 23921
Office
Unavailable
Facility
$448.17
No comparable office rate is available.
Rest Of Missouri
Missouri · 23921
Office
Unavailable
Facility
$426.09
No comparable office rate is available.
Mississippi
Mississippi · 23921
Office
Unavailable
Facility
$416.44
No comparable office rate is available.
Montana**
Montana · 23921
Office
Unavailable
Facility
$459.18
No comparable office rate is available.
North Carolina
North Carolina · 23921
Office
Unavailable
Facility
$429.20
No comparable office rate is available.
North Dakota**
North Dakota · 23921
Office
Unavailable
Facility
$435.45
No comparable office rate is available.
Nebraska
Nebraska · 23921
Office
Unavailable
Facility
$416.41
No comparable office rate is available.
New Hampshire
New Hampshire · 23921
Office
Unavailable
Facility
$463.80
No comparable office rate is available.
Northern Nj
New Jersey · 23921
Office
Unavailable
Facility
$510.98
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 23921
Office
Unavailable
Facility
$492.02
No comparable office rate is available.
New Mexico
New Mexico · 23921
Office
Unavailable
Facility
$448.00
No comparable office rate is available.
Nevada**
Nevada · 23921
Office
Unavailable
Facility
$452.80
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 23921
Office
Unavailable
Facility
$549.54
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 23921
Office
Unavailable
Facility
$498.18
No comparable office rate is available.
Queens
New York · 23921
Office
Unavailable
Facility
$531.28
No comparable office rate is available.
Rest Of New York
New York · 23921
Office
Unavailable
Facility
$435.72
No comparable office rate is available.
Ohio
Ohio · 23921
Office
Unavailable
Facility
$439.33
No comparable office rate is available.
Oklahoma
Oklahoma · 23921
Office
Unavailable
Facility
$425.41
No comparable office rate is available.
Portland
Oregon · 23921
Office
Unavailable
Facility
$477.82
No comparable office rate is available.
Rest Of Oregon
Oregon · 23921
Office
Unavailable
Facility
$446.43
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 23921
Office
Unavailable
Facility
$479.90
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 23921
Office
Unavailable
Facility
$437.97
No comparable office rate is available.
Puerto Rico
Puerto Rico · 23921
Office
Unavailable
Facility
$461.22
No comparable office rate is available.
Rhode Island
Rhode Island · 23921
Office
Unavailable
Facility
$466.16
No comparable office rate is available.
South Carolina
South Carolina · 23921
Office
Unavailable
Facility
$435.56
No comparable office rate is available.
South Dakota**
South Dakota · 23921
Office
Unavailable
Facility
$432.65
No comparable office rate is available.
Tennessee
Tennessee · 23921
Office
Unavailable
Facility
$419.52
No comparable office rate is available.
Austin
Texas · 23921
Office
Unavailable
Facility
$468.57
No comparable office rate is available.
Beaumont
Texas · 23921
Office
Unavailable
Facility
$435.46
No comparable office rate is available.
Brazoria
Texas · 23921
Office
Unavailable
Facility
$449.84
No comparable office rate is available.
Dallas
Texas · 23921
Office
Unavailable
Facility
$454.32
No comparable office rate is available.
Fort Worth
Texas · 23921
Office
Unavailable
Facility
$452.51
No comparable office rate is available.
Galveston
Texas · 23921
Office
Unavailable
Facility
$452.23
No comparable office rate is available.
Houston
Texas · 23921
Office
Unavailable
Facility
$474.19
No comparable office rate is available.
Rest Of Texas
Texas · 23921
Office
Unavailable
Facility
$443.50
No comparable office rate is available.
Utah
Utah · 23921
Office
Unavailable
Facility
$441.21
No comparable office rate is available.
Virginia
Virginia · 23921
Office
Unavailable
Facility
$443.52
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 23921
Office
Unavailable
Facility
$461.22
No comparable office rate is available.
Vermont
Vermont · 23921
Office
Unavailable
Facility
$437.13
No comparable office rate is available.
Rest Of Washington
Washington · 23921
Office
Unavailable
Facility
$464.44
No comparable office rate is available.
Seattle (King Cnty)
Washington · 23921
Office
Unavailable
Facility
$514.09
No comparable office rate is available.
Wisconsin
Wisconsin · 23921
Office
Unavailable
Facility
$421.75
No comparable office rate is available.
West Virginia
West Virginia · 23921
Office
Unavailable
Facility
$446.04
No comparable office rate is available.
Wyoming**
Wyoming · 23921
Office
Unavailable
Facility
$448.84
No comparable office rate is available.
See how rates vary across the country
23921 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 23921 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$498.69
$453.35 × 110% = $498.69
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 23921 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,251
- Code
- 23921
- Physician work
- 5.58
- Practice expense
- 6.97
- Malpractice
- 1.20
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.58 | × 1.005 | 5.6079 |
| Practice expense | 6.97 | × 0.988 | 6.8864 |
| Malpractice | 1.20 | × 0.899 | 1.0788 |
| Total RVUs | 13.5731 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$453.35
Open 23921 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.58 | 1.005 |
| Practice expense | 6.97 | 0.988 |
| Malpractice | 1.2 | 0.899 |
(5.58 × 1.005 + 6.97 × 0.988 + 1.2 × 0.899) × $33.4009 = $453.35
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
23921 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $453.35 | RVU26D |
| 2026-07-01 | Not available in this setting | $453.35 | RVU26C |
| 2026-04-01 | Not available in this setting | $453.35 | RVU26B |
| 2026-01-01 | Not available in this setting | $453.35 | RVU26A |
| 2025-10-01 | Not available in this setting | $469.37 | RVU25D |
| 2025-07-01 | Not available in this setting | $469.37 | RVU25C |
| 2025-04-01 | Not available in this setting | $469.37 | RVU25B |
| 2025-01-01 | Not available in this setting | $469.37 | RVU25A |
23921 billing questions
How is this different from the shoulder disarticulation code?
This code is for closing the shoulder-disarticulation wound in a later operative session. The shoulder disarticulation code describes creating the amputation, not its delayed closure.
What documentation supports reporting this service?
The operative report should identify the prior shoulder disarticulation site, explain that the wound remained open, and describe the surgical steps used to close it.
Can routine postoperative wound care be reported separately?
Related postoperative care is included in the 90-day global period. This code describes the operative secondary closure, not routine care during recovery.
How are additional procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction, with payment at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services are not paid for this code. Co-surgeons and team surgery are not permitted.
How should bilateral closure be reported?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,24823802,,Arthrd glenohumeral jt w/grf,A,,17.96,13.61,NA,13.61,,3.83,35.40,35.40,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24923900,,Interthoracoscplr amputation,A,,20.20,13.13,NA,13.13,,4.30,37.63,37.63,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25023920,,Disarticulation shoulder,A,,15.82,11.79,NA,11.79,,3.36,30.97,30.97,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25123921,,Disarticulation sho sec clsr,A,,5.58,6.97,NA,6.97,,1.20,13.75,13.75,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25223929,,Unlisted procedure shoulder,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25323930,,I&d upr a/e dp absc/hmtma,A,,2.92,7.88,,2.61,,0.61,11.41,6.14,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25423931,,I&d upr a/e bursa,A,,1.79,7.56,,2.61,,0.35,9.70,4.75,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503