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CMS RVU26D · Effective 2026-10-01

23065 in Merced

Office / nonfacility

$241.23

Base rate per service

Facility setting

$148.25

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.

Musculoskeletal surgery

About 23065: Deep shoulder soft-tissue biopsy

Report this code for an open biopsy of deep soft tissue in the shoulder region when tissue is sampled for diagnosis rather than completely excised.

This service involves surgically obtaining a tissue sample from deep soft tissue in the shoulder region, such as a deep soft-tissue mass. The surgeon makes an incision to reach the target and removes tissue for diagnostic examination; the procedure is a biopsy, not complete removal of a lesion. Orthopedic surgeons and other surgeons who evaluate shoulder-region masses may perform it in an outpatient operating room or hospital setting.

Select the code when the sampled structure is deep shoulder soft tissue. A record supporting the claim identifies the target and its location, documents the approach and tissue obtained, and distinguishes sampling from complete excision. The code has a 10-day global period, so related postoperative visits during that period are included. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 23065

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU2.24 · 32%
  • Practice expense (office) RVU4.34 · 63%
  • Malpractice RVU0.35 · 5%

276

Medicare services in 2024 · #4055 by national volume

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.

23065 compared with similar codes

Office rates for Merced, from the same CMS release.

23066

Shoulder biopsy

Deep tissue

$657.39

Use 23065 for a deep soft-tissue target in the shoulder region; 23066 is for biopsy of bone in that region.

23071

Shoulder mass excision

Subcutaneous, 3 cm or larger

No office rate

This code describes deep soft-tissue sampling for diagnosis. Code 23071 is for complete excision of a subcutaneous shoulder lesion measuring 3 cm or more.

23073

Shoulder tumor excision

Deep, 5 cm or larger

No office rate

Use this code when deep shoulder soft tissue is sampled for diagnosis. Code 23073 describes complete excision of a deep shoulder tumor measuring 5 cm or more.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 23065 is $242.24—$1.01 higher than the $241.23 rate in Merced. Both use the same code, release and participation basis.

23065 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $241.23

  2. Bakersfield

    $242.24

    $1.01 higher than Merced

  3. Chico

    $241.23

    The same base rate than Merced

  4. El Centro

    $241.29

    $0.06 higher than Merced

  5. Fresno

    $241.23

    The same base rate than Merced

  6. Hanford-Corcoran

    $241.23

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $257.14

    $15.91 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 23065 ranges from $205.36 in Arkansas to $298.35 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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

  • Madera

    California · 23065

    Office

    $241.23

    Facility

    $148.25

    The same base rate than Merced for the office setting.

  • Modesto

    California · 23065

    Office

    $241.23

    Facility

    $148.25

    The same base rate than Merced for the office setting.

  • Napa

    California · 23065

    Office

    $276.53

    Facility

    $164.71

    $35.30 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 23065

    Office

    $255.54

    Facility

    $155.26

    $14.31 higher than Merced for the office setting.

  • Redding

    California · 23065

    Office

    $241.23

    Facility

    $148.25

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 23065

    Office

    $241.23

    Facility

    $148.25

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 23065

    Office

    $245.01

    Facility

    $152.03

    $3.78 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 23065

    Office

    $252.37

    Facility

    $153.70

    $11.14 higher than Merced for the office setting.

  • Salinas

    California · 23065

    Office

    $251.41

    Facility

    $153.08

    $10.18 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 23065

    Office

    $256.77

    Facility

    $155.30

    $15.54 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 23065

    Office

    $291.69

    Facility

    $172.06

    $50.46 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 23065

    Office

    $291.29

    Facility

    $171.67

    $50.06 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 23065

    Office

    $298.35

    Facility

    $176.01

    $57.12 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 23065

    Office

    $296.72

    Facility

    $174.38

    $55.49 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 23065

    Office

    $247.47

    Facility

    $150.83

    $6.24 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 23065

    Office

    $258.78

    Facility

    $155.70

    $17.55 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 23065

    Office

    $252.20

    Facility

    $153.28

    $10.97 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 23065

    Office

    $261.34

    Facility

    $157.16

    $20.11 higher than Merced for the office setting.

  • Stockton

    California · 23065

    Office

    $241.23

    Facility

    $148.25

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 23065

    Office

    $275.95

    Facility

    $164.14

    $34.72 higher than Merced for the office setting.

  • Visalia

    California · 23065

    Office

    $241.23

    Facility

    $148.25

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 23065

    Office

    $241.23

    Facility

    $148.25

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 23065

    Office

    $262.63

    Facility

    $162.69

    $21.40 higher than Merced for the office setting.

  • Miami

    Florida · 23065

    Office

    $255.29

    Facility

    $166.97

    $14.06 higher than Merced for the office setting.

  • Chicago

    Illinois · 23065

    Office

    $247.86

    Facility

    $162.59

    $6.63 higher than Merced for the office setting.

  • Manhattan

    New York · 23065

    Office

    $266.59

    Facility

    $168.01

    $25.36 higher than Merced for the office setting.

  • Alaska*

    Alaska · 23065

    Office

    $273.05

    Facility

    $182.70

    $31.82 higher than Merced for the office setting.

  • Alabama

    Alabama · 23065

    Office

    $208.27

    Facility

    $134.04

    $32.96 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 23065

    Office

    $205.36

    Facility

    $132.48

    $35.87 lower than Merced for the office setting.

  • Arizona

    Arizona · 23065

    Office

    $225.29

    Facility

    $143.08

    $15.94 lower than Merced for the office setting.

  • Colorado

    Colorado · 23065

    Office

    $239.08

    Facility

    $148.82

    $2.15 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 23065

    Office

    $246.58

    Facility

    $155.21

    $5.35 higher than Merced for the office setting.

  • Delaware

    Delaware · 23065

    Office

    $228.92

    Facility

    $145.10

    $12.31 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 23065

    Office

    $242.80

    Facility

    $156.86

    $1.57 higher than Merced for the office setting.

  • Rest Of Florida

    Florida · 23065

    Office

    $230.97

    Facility

    $149.86

    $10.26 lower than Merced for the office setting.

  • Atlanta

    Georgia · 23065

    Office

    $236.36

    Facility

    $150.17

    $4.87 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 23065

    Office

    $218.06

    Facility

    $142.38

    $23.17 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 23065

    Office

    $246.41

    Facility

    $149.94

    $5.18 higher than Merced for the office setting.

  • Iowa

    Iowa · 23065

    Office

    $212.10

    Facility

    $134.47

    $29.13 lower than Merced for the office setting.

  • Idaho

    Idaho · 23065

    Office

    $213.71

    Facility

    $135.66

    $27.52 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 23065

    Office

    $231.73

    Facility

    $153.67

    $9.50 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 23065

    Office

    $225.44

    Facility

    $147.98

    $15.79 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 23065

    Office

    $244.93

    Facility

    $157.80

    $3.70 higher than Merced for the office setting.

  • Indiana

    Indiana · 23065

    Office

    $214.88

    Facility

    $136.23

    $26.35 lower than Merced for the office setting.

  • Kansas

    Kansas · 23065

    Office

    $211.75

    Facility

    $135.06

    $29.48 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 23065

    Office

    $214.38

    Facility

    $138.96

    $26.85 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 23065

    Office

    $224.51

    Facility

    $144.67

    $16.72 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 23065

    Office

    $214.31

    Facility

    $139.22

    $26.92 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 23065

    Office

    $261.37

    Facility

    $160.08

    $20.14 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 23065

    Office

    $237.98

    Facility

    $148.64

    $3.25 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 23065

    Office

    $246.02

    Facility

    $154.99

    $4.79 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 23065

    Office

    $233.00

    Facility

    $147.14

    $8.23 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 23065

    Office

    $215.45

    Facility

    $137.40

    $25.78 lower than Merced for the office setting.

  • Southern Maine

    Maine · 23065

    Office

    $225.85

    Facility

    $141.78

    $15.38 lower than Merced for the office setting.

  • Detroit

    Michigan · 23065

    Office

    $234.41

    Facility

    $152.55

    $6.82 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 23065

    Office

    $220.36

    Facility

    $142.91

    $20.87 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 23065

    Office

    $227.44

    Facility

    $140.14

    $13.79 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 23065

    Office

    $222.36

    Facility

    $142.69

    $18.87 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 23065

    Office

    $224.53

    Facility

    $143.77

    $16.70 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 23065

    Office

    $211.16

    Facility

    $138.03

    $30.07 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 23065

    Office

    $208.27

    Facility

    $135.22

    $32.96 lower than Merced for the office setting.

  • Montana**

    Montana · 23065

    Office

    $231.44

    Facility

    $146.61

    $9.79 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 23065

    Office

    $217.54

    Facility

    $138.38

    $23.69 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 23065

    Office

    $224.52

    Facility

    $139.69

    $16.71 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 23065

    Office

    $213.03

    Facility

    $134.73

    $28.20 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 23065

    Office

    $235.95

    Facility

    $147.63

    $5.28 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 23065

    Office

    $260.17

    Facility

    $161.76

    $18.94 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 23065

    Office

    $248.93

    Facility

    $156.29

    $7.70 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 23065

    Office

    $221.79

    Facility

    $143.99

    $19.44 lower than Merced for the office setting.

  • Nevada**

    Nevada · 23065

    Office

    $229.66

    Facility

    $144.74

    $11.57 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 23065

    Office

    $273.67

    Facility

    $172.80

    $32.44 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 23065

    Office

    $251.06

    Facility

    $158.16

    $9.83 higher than Merced for the office setting.

  • Queens

    New York · 23065

    Office

    $267.81

    Facility

    $167.53

    $26.58 higher than Merced for the office setting.

  • Rest Of New York

    New York · 23065

    Office

    $220.75

    Facility

    $140.15

    $20.48 lower than Merced for the office setting.

  • Ohio

    Ohio · 23065

    Office

    $218.95

    Facility

    $141.49

    $22.28 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 23065

    Office

    $213.35

    Facility

    $137.59

    $27.88 lower than Merced for the office setting.

  • Portland

    Oregon · 23065

    Office

    $245.76

    Facility

    $151.51

    $4.53 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 23065

    Office

    $227.42

    Facility

    $142.92

    $13.81 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 23065

    Office

    $241.01

    Facility

    $152.70

    $0.22 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 23065

    Office

    $218.94

    Facility

    $141.06

    $22.29 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 23065

    Office

    $232.89

    Facility

    $147.12

    $8.34 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 23065

    Office

    $236.41

    Facility

    $148.77

    $4.82 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 23065

    Office

    $218.70

    Facility

    $140.31

    $22.53 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 23065

    Office

    $223.71

    Facility

    $138.87

    $17.52 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 23065

    Office

    $212.86

    Facility

    $135.75

    $28.37 lower than Merced for the office setting.

  • Austin

    Texas · 23065

    Office

    $238.69

    Facility

    $148.93

    $2.54 lower than Merced for the office setting.

  • Beaumont

    Texas · 23065

    Office

    $217.59

    Facility

    $140.39

    $23.64 lower than Merced for the office setting.

  • Brazoria

    Texas · 23065

    Office

    $228.19

    Facility

    $144.12

    $13.04 lower than Merced for the office setting.

  • Dallas

    Texas · 23065

    Office

    $229.90

    Facility

    $145.40

    $11.33 lower than Merced for the office setting.

  • Fort Worth

    Texas · 23065

    Office

    $228.60

    Facility

    $144.95

    $12.63 lower than Merced for the office setting.

  • Galveston

    Texas · 23065

    Office

    $229.04

    Facility

    $144.80

    $12.19 lower than Merced for the office setting.

  • Houston

    Texas · 23065

    Office

    $235.45

    Facility

    $151.20

    $5.78 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 23065

    Office

    $222.94

    Facility

    $142.43

    $18.29 lower than Merced for the office setting.

  • Utah

    Utah · 23065

    Office

    $221.58

    Facility

    $141.83

    $19.65 lower than Merced for the office setting.

  • Virginia

    Virginia · 23065

    Office

    $225.57

    Facility

    $142.17

    $15.66 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 23065

    Office

    $232.89

    Facility

    $147.12

    $8.34 lower than Merced for the office setting.

  • Vermont

    Vermont · 23065

    Office

    $224.24

    Facility

    $140.25

    $16.99 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 23065

    Office

    $237.33

    Facility

    $148.00

    $3.90 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 23065

    Office

    $265.98

    Facility

    $161.88

    $24.75 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 23065

    Office

    $217.29

    Facility

    $136.02

    $23.94 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 23065

    Office

    $217.52

    Facility

    $143.79

    $23.71 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 23065

    Office

    $228.43

    Facility

    $143.59

    $12.80 lower than Merced for the office setting.

See how rates vary across the country

23065 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$205.36

$273.05

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$273.051
AL$208.271
AR$205.361
AZ$225.291
CA$241.23–$298.3529
CO$239.081
CT$246.581
DC$262.631
DE$228.921
FL$230.97–$255.293
GA$218.06–$236.362
GU$246.411
HI$246.411
IA$212.101
ID$213.711
IL$225.44–$247.864
IN$214.881
KS$211.751
KY$214.381
LA$214.31–$224.512
MA$237.98–$261.372
MD$233.00–$262.633
ME$215.45–$225.852
MI$220.36–$234.412
MN$227.441
MO$211.16–$224.533
MS$208.271
MT$231.441
NC$217.541
ND$224.521
NE$213.031
NH$235.951
NJ$248.93–$260.172
NM$221.791
NV$229.661
NY$220.75–$273.675
OH$218.951
OK$213.351
OR$227.42–$245.762
PA$218.94–$241.012
PR$232.891
RI$236.411
SC$218.701
SD$223.711
TN$212.861
TX$217.59–$238.698
UT$221.581
VA$225.57–$262.632
VI$232.891
VT$224.241
WA$237.33–$265.982
WI$217.291
WV$217.521
WY$228.431

Explore 23065 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, 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.

Browse all communities in California →

Why are the office and facility amounts different?

For 23065 in Merced, the physician’s office rate is $241.23 and the facility-setting rate is $148.25: a difference of $92.98.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 23065 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$265.35

$241.23 × 110% = $265.35

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.

Compare your contract offer →

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 23065 in Merced.

PPRRVU2026_Oct_nonQPP.csv

2,155

Code
23065
Physician work
2.24
Practice expense
4.34
Malpractice
0.35

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 23065 in Merced
ComponentRVULocality factorAdjusted
Physician work2.24× 1.0172.2781
Practice expense4.34× 1.0964.7566
Malpractice0.35× 0.5360.1876
Total RVUs7.2223
Conversion factor× 33.4009

Office / nonfacility rate, Merced$241.23

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 23065 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.241.017
Practice expense4.341.096
Malpractice0.350.536

(2.24 × 1.017 + 4.34 × 1.096 + 0.35 × 0.536) × $33.4009 = $241.23

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.241.017
Practice expense1.81.096
Malpractice0.350.536

(2.24 × 1.017 + 1.8 × 1.096 + 0.35 × 0.536) × $33.4009 = $148.25

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

23065 · Office / nonfacility

$241.23

Effective 2026-10-01

The base rate is $13.79 higher than on 2025-10-01, moving from $227.44 to $241.23 (6.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $227.44changed to$241.23

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.30 changed to 2.24
    • Practice expense RVU 4.12 changed to 4.34
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $227.44

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$241.23$148.25RVU26D
2026-07-01$241.23$148.25RVU26C
2026-04-01$241.23$148.25RVU26B
2026-01-01$241.23$148.25RVU26A
2025-10-01$227.44$158.85RVU25D
2025-07-01$227.44$158.85RVU25C
2025-04-01$227.44$158.85RVU25B
2025-01-01$227.44$158.85RVU25A

23065 billing questions

How is this code distinguished from 23066?

This code is for a deep soft-tissue biopsy in the shoulder region. Use 23066 when the biopsy target is bone.

Should this code be used when the entire mass is removed?

No. It represents sampling for diagnosis, not complete lesion excision. For a complete excision, select the applicable shoulder excision code based on tissue depth and lesion size.

What documentation supports reporting this biopsy?

Document the shoulder-region target, that it is deep soft tissue, the biopsy approach, and the tissue sampled. The operative record should make clear that tissue was obtained for diagnosis rather than the lesion being completely excised.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in this procedure's payment.

How does Medicare handle bilateral biopsies or another procedure in the same session?

A bilateral procedure reported with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are reduced to 50%.

Can an assistant or another surgeon be reported for this procedure?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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 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.

RVUs for 23065PPRRVU2026_Oct_nonQPP.csv, line 2,155 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet