No office rate
Both address a benign lesion in the scapula, but 23146 is distinguished by use of allograft. Select the code that matches the graft approach documented in the operative report.
On this page
CMS RVU26D · Effective 2026-10-01
23146 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$581.62
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.
Orthopedic surgery
About 23146: Scapular bone lesion curettage with allograft
Reports surgical curettage or excision of a benign bone lesion in the scapula when the resulting defect is filled with donor bone graft.
An orthopedic surgeon removes or curettes a benign bone cyst or tumor in the scapula and fills the resulting bone defect with allograft. The service is performed in an operative setting when the lesion requires surgical treatment; it is distinct from removing a lesion in the clavicle or humerus. The allograft is the differentiating feature of this scapular lesion procedure.
Select the code when the operative report supports the scapular site, removal or curettage of a benign lesion, and placement of allograft. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 23146
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.88 · 44%
- Practice expense (office) RVU8.29 · 46%
- Malpractice RVU1.68 · 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.
23146 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
The same code, a different location
How does Wyoming** compare?
23146 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · 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 Wyoming 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 · 23146
Office
Unavailable
Facility
$537.24
No comparable office rate is available.
Arkansas
Arkansas · 23146
Office
Unavailable
Facility
$529.95
No comparable office rate is available.
Arizona
Arizona · 23146
Office
Unavailable
Facility
$579.54
No comparable office rate is available.
Bakersfield
California · 23146
Office
Unavailable
Facility
$605.85
No comparable office rate is available.
Chico
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
El Centro
California · 23146
Office
Unavailable
Facility
$601.51
No comparable office rate is available.
Fresno
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
Hanford-Corcoran
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
Madera
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
Merced
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
Modesto
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
Napa
California · 23146
Office
Unavailable
Facility
$673.23
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 23146
Office
Unavailable
Facility
$632.82
No comparable office rate is available.
Redding
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
Rest Of California
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 23146
Office
Unavailable
Facility
$619.28
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 23146
Office
Unavailable
Facility
$624.78
No comparable office rate is available.
Salinas
California · 23146
Office
Unavailable
Facility
$622.35
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 23146
Office
Unavailable
Facility
$632.67
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 23146
Office
Unavailable
Facility
$704.38
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 23146
Office
Unavailable
Facility
$702.47
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 23146
Office
Unavailable
Facility
$721.51
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 23146
Office
Unavailable
Facility
$713.71
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 23146
Office
Unavailable
Facility
$613.13
No comparable office rate is available.
Santa Cruz-Watsonville
California · 23146
Office
Unavailable
Facility
$635.23
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 23146
Office
Unavailable
Facility
$623.50
No comparable office rate is available.
Santa Rosa-Petaluma
California · 23146
Office
Unavailable
Facility
$641.20
No comparable office rate is available.
Stockton
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
Vallejo
California · 23146
Office
Unavailable
Facility
$670.48
No comparable office rate is available.
Visalia
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
Yuba City
California · 23146
Office
Unavailable
Facility
$601.23
No comparable office rate is available.
Colorado
Colorado · 23146
Office
Unavailable
Facility
$604.80
No comparable office rate is available.
Connecticut
Connecticut · 23146
Office
Unavailable
Facility
$634.57
No comparable office rate is available.
Delaware
Delaware · 23146
Office
Unavailable
Facility
$588.53
No comparable office rate is available.
Fort Lauderdale
Florida · 23146
Office
Unavailable
Facility
$645.15
No comparable office rate is available.
Rest Of Florida
Florida · 23146
Office
Unavailable
Facility
$612.25
No comparable office rate is available.
Atlanta
Georgia · 23146
Office
Unavailable
Facility
$612.70
No comparable office rate is available.
Rest Of Georgia
Georgia · 23146
Office
Unavailable
Facility
$577.08
No comparable office rate is available.
Hawaii, Guam
Hawaii · 23146
Office
Unavailable
Facility
$610.52
No comparable office rate is available.
Iowa
Iowa · 23146
Office
Unavailable
Facility
$538.83
No comparable office rate is available.
Idaho
Idaho · 23146
Office
Unavailable
Facility
$544.48
No comparable office rate is available.
East St. Louis
Illinois · 23146
Office
Unavailable
Facility
$630.95
No comparable office rate is available.
Rest Of Illinois
Illinois · 23146
Office
Unavailable
Facility
$603.71
No comparable office rate is available.
Suburban Chicago
Illinois · 23146
Office
Unavailable
Facility
$648.84
No comparable office rate is available.
Indiana
Indiana · 23146
Office
Unavailable
Facility
$547.15
No comparable office rate is available.
Kansas
Kansas · 23146
Office
Unavailable
Facility
$541.79
No comparable office rate is available.
Kentucky
Kentucky · 23146
Office
Unavailable
Facility
$560.70
No comparable office rate is available.
New Orleans
Louisiana · 23146
Office
Unavailable
Facility
$587.50
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 23146
Office
Unavailable
Facility
$562.01
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 23146
Office
Unavailable
Facility
$654.54
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 23146
Office
Unavailable
Facility
$603.70
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 23146
Office
Unavailable
Facility
$633.93
No comparable office rate is available.
Rest Of Maryland
Maryland · 23146
Office
Unavailable
Facility
$597.56
No comparable office rate is available.
Rest Of Maine
Maine · 23146
Office
Unavailable
Facility
$552.84
No comparable office rate is available.
Southern Maine
Maine · 23146
Office
Unavailable
Facility
$573.01
No comparable office rate is available.
Detroit
Michigan · 23146
Office
Unavailable
Facility
$625.01
No comparable office rate is available.
Rest Of Michigan
Michigan · 23146
Office
Unavailable
Facility
$579.35
No comparable office rate is available.
Minnesota
Minnesota · 23146
Office
Unavailable
Facility
$564.73
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 23146
Office
Unavailable
Facility
$578.02
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 23146
Office
Unavailable
Facility
$583.03
No comparable office rate is available.
Rest Of Missouri
Missouri · 23146
Office
Unavailable
Facility
$556.54
No comparable office rate is available.
Mississippi
Mississippi · 23146
Office
Unavailable
Facility
$543.07
No comparable office rate is available.
Montana**
Montana · 23146
Office
Unavailable
Facility
$596.09
No comparable office rate is available.
North Carolina
North Carolina · 23146
Office
Unavailable
Facility
$557.40
No comparable office rate is available.
North Dakota**
North Dakota · 23146
Office
Unavailable
Facility
$562.87
No comparable office rate is available.
Nebraska
Nebraska · 23146
Office
Unavailable
Facility
$539.98
No comparable office rate is available.
New Hampshire
New Hampshire · 23146
Office
Unavailable
Facility
$600.54
No comparable office rate is available.
Northern Nj
New Jersey · 23146
Office
Unavailable
Facility
$660.91
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 23146
Office
Unavailable
Facility
$637.65
No comparable office rate is available.
New Mexico
New Mexico · 23146
Office
Unavailable
Facility
$584.50
No comparable office rate is available.
Nevada**
Nevada · 23146
Office
Unavailable
Facility
$587.11
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 23146
Office
Unavailable
Facility
$713.47
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 23146
Office
Unavailable
Facility
$646.14
No comparable office rate is available.
Queens
New York · 23146
Office
Unavailable
Facility
$688.25
No comparable office rate is available.
Rest Of New York
New York · 23146
Office
Unavailable
Facility
$565.70
No comparable office rate is available.
Ohio
Ohio · 23146
Office
Unavailable
Facility
$572.57
No comparable office rate is available.
Oklahoma
Oklahoma · 23146
Office
Unavailable
Facility
$554.07
No comparable office rate is available.
Portland
Oregon · 23146
Office
Unavailable
Facility
$616.79
No comparable office rate is available.
Rest Of Oregon
Oregon · 23146
Office
Unavailable
Facility
$578.43
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 23146
Office
Unavailable
Facility
$623.13
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 23146
Office
Unavailable
Facility
$570.41
No comparable office rate is available.
Puerto Rico
Puerto Rico · 23146
Office
Unavailable
Facility
$598.41
No comparable office rate is available.
Rhode Island
Rhode Island · 23146
Office
Unavailable
Facility
$604.28
No comparable office rate is available.
South Carolina
South Carolina · 23146
Office
Unavailable
Facility
$566.75
No comparable office rate is available.
South Dakota**
South Dakota · 23146
Office
Unavailable
Facility
$558.95
No comparable office rate is available.
Tennessee
Tennessee · 23146
Office
Unavailable
Facility
$545.03
No comparable office rate is available.
Austin
Texas · 23146
Office
Unavailable
Facility
$606.40
No comparable office rate is available.
Beaumont
Texas · 23146
Office
Unavailable
Facility
$567.30
No comparable office rate is available.
Brazoria
Texas · 23146
Office
Unavailable
Facility
$583.47
No comparable office rate is available.
Dallas
Texas · 23146
Office
Unavailable
Facility
$589.50
No comparable office rate is available.
Fort Worth
Texas · 23146
Office
Unavailable
Facility
$587.46
No comparable office rate is available.
Galveston
Texas · 23146
Office
Unavailable
Facility
$586.72
No comparable office rate is available.
Houston
Texas · 23146
Office
Unavailable
Facility
$617.47
No comparable office rate is available.
Rest Of Texas
Texas · 23146
Office
Unavailable
Facility
$576.64
No comparable office rate is available.
Utah
Utah · 23146
Office
Unavailable
Facility
$573.87
No comparable office rate is available.
Virginia
Virginia · 23146
Office
Unavailable
Facility
$575.00
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 23146
Office
Unavailable
Facility
$598.41
No comparable office rate is available.
Vermont
Vermont · 23146
Office
Unavailable
Facility
$565.72
No comparable office rate is available.
Rest Of Washington
Washington · 23146
Office
Unavailable
Facility
$600.89
No comparable office rate is available.
Seattle (King Cnty)
Washington · 23146
Office
Unavailable
Facility
$661.95
No comparable office rate is available.
Wisconsin
Wisconsin · 23146
Office
Unavailable
Facility
$545.75
No comparable office rate is available.
West Virginia
West Virginia · 23146
Office
Unavailable
Facility
$584.12
No comparable office rate is available.
See how rates vary across the country
23146 · 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?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 23146 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$639.78
$581.62 × 110% = $639.78
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 23146 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,173
- Code
- 23146
- Physician work
- 7.88
- Practice expense
- 8.29
- Malpractice
- 1.68
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.88 | × 1.000 | 7.8800 |
| Practice expense | 8.29 | × 1.000 | 8.2900 |
| Malpractice | 1.68 | × 0.740 | 1.2432 |
| Total RVUs | 17.4132 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$581.62
Open 23146 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.88 | 1 |
| Practice expense | 8.29 | 1 |
| Malpractice | 1.68 | 0.74 |
(7.88 × 1 + 8.29 × 1 + 1.68 × 0.74) × $33.4009 = $581.62
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
23146 · 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 | $581.62 | RVU26D |
| 2026-07-01 | Not available in this setting | $581.62 | RVU26C |
| 2026-04-01 | Not available in this setting | $581.62 | RVU26B |
| 2026-01-01 | Not available in this setting | $581.62 | RVU26A |
| 2025-10-01 | Not available in this setting | $608.74 | RVU25D |
| 2025-07-01 | Not available in this setting | $608.74 | RVU25C |
| 2025-04-01 | Not available in this setting | $608.74 | RVU25B |
| 2025-01-01 | Not available in this setting | $608.74 | RVU25A |
23146 billing questions
When should this code be selected instead of 23145?
Use 23146 for a scapular lesion procedure that uses allograft. Code 23145 represents a different graft approach for a scapular lesion.
Does the code cover removal of a humeral lesion?
No. This code is for a lesion in the scapula; humeral lesion procedures are reported from the humerus code series, such as 23150 or 23155.
What documentation supports reporting this code?
The operative report should identify the scapular lesion, describe its removal or curettage, and document use of allograft to fill the bone defect.
How is bilateral reporting handled?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
2,17023130,,Acromp/acromionectomy prtl,A,,7.58,8.52,NA,8.52,,1.59,17.69,17.69,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17123140,,Removal of bone lesion,A,,6.94,7.50,NA,7.50,,1.47,15.91,15.91,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17223145,,Removal of bone lesion,A,,9.17,8.55,NA,8.55,,1.95,19.67,19.67,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17323146,,Removal of bone lesion,A,,7.88,8.29,NA,8.29,,1.68,17.85,17.85,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17423150,,Removal of humerus lesion,A,,8.69,8.40,NA,8.40,,1.85,18.94,18.94,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17523155,,Removal of humerus lesion,A,,10.59,9.57,NA,9.57,,2.25,22.41,22.41,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17623156,,Removal of humerus lesion,A,,8.88,8.46,NA,8.46,,1.90,19.24,19.24,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,