No office rate
Use 23334 for removal of a humeral or glenoid component. Use 23335 when the total shoulder prosthesis is removed.
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CMS RVU26D · Effective 2026-10-01
23335 Prosthesis removal Medicare reimbursement rates in Alabama
Reports operative removal of a total shoulder prosthesis, including associated debridement, when the implant is removed rather than revised or replaced. Compare 23335 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 23335 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1043.44
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 23335: Total shoulder prosthesis removal
Reports operative removal of a total shoulder prosthesis, including associated debridement, when the implant is removed rather than revised or replaced.
An orthopedic surgeon uses this code when removing a total shoulder prosthesis, including its humeral and glenoid components. The operation may be performed for an infected, loose, or failed implant, including as a stage before a later reconstruction. The service includes debridement associated with removing the prosthesis. Medicare claims for this procedure are predominantly facility-based.
Choose this code when the total prosthesis is removed; removal of only a humeral or glenoid component is represented by 23334. Operative documentation should identify the implant and establish that the total prosthesis was removed, along with the reason for surgery and the work performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery is not paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 23335
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU18.53 · 54%
- Practice expense (office) RVU12.10 · 35%
- Malpractice RVU3.75 · 11%
566
Medicare services in 2024 · #3449 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.
23335 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
23473 describes revision of one shoulder arthroplasty component. 23335 describes removal of the total prosthesis rather than revision of one component.
No office rate
23474 describes revision of both components of a shoulder arthroplasty. 23335 is for removal of the total prosthesis, not revision replacement of both components.
$566.27
20680 is used for removal of deep fixation hardware such as plates, screws, or rods. A shoulder joint prosthesis is reported with the prosthesis-removal code.
Compare 23335 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$1043.44
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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 23335 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
2,191
- Code
- 23335
- Physician work
- 18.53
- Practice expense
- 12.10
- Malpractice
- 3.75
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.53 | × 1.000 | 18.5300 |
| Practice expense | 12.10 | × 0.875 | 10.5875 |
| Malpractice | 3.75 | × 0.566 | 2.1225 |
| Total RVUs | 31.2400 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$1043.44
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.53 | 1 |
| Practice expense | 12.1 | 0.875 |
| Malpractice | 3.75 | 0.566 |
(18.53 × 1 + 12.1 × 0.875 + 3.75 × 0.566) × $33.4009 = $1043.44
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.
23335 billing questions
When should I report 23335 instead of 23334?
Report 23335 when the total shoulder prosthesis is removed. Code 23334 represents removal of a humeral or glenoid component rather than the total prosthesis.
Is debridement separately reported with 23335?
Debridement associated with removal of the shoulder prosthesis is included in this service. The operative note should support the implant removal and the extent of work performed.
Can 23335 be reported when the prosthesis is revised or replaced?
When the operation revises or replaces shoulder arthroplasty components, compare the applicable revision arthroplasty code, such as 23473 or 23474. Those codes describe revision work rather than removal alone.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are bilateral procedures and surgical assistance handled?
CMS pays bilateral reporting with modifier 50 at 150%. Assistant-at-surgery services are not paid; co-surgeon payment requires supporting documentation, and 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 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.
2,18823330,,Remove shoulder foreign body,A,,1.85,7.58,,2.73,,0.40,9.83,4.98,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18923333,,Remove shoulder fb deep,A,,5.85,6.66,NA,6.66,,1.25,13.76,13.76,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19023334,,Shoulder prosthesis removal,A,,15.11,11.05,NA,11.05,,3.06,29.22,29.22,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19123335,,Shoulder prosthesis removal,A,,18.53,12.10,NA,12.10,,3.75,34.38,34.38,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19223350,,Injection for shoulder x-ray,A,,0.98,3.63,,0.19,,0.09,4.70,1.26,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19323395,,Muscle transfer shoulder/arm,A,,18.08,13.46,NA,13.46,,3.72,35.26,35.26,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19423397,,Muscle transfers,A,,16.34,11.40,NA,11.40,,3.48,31.22,31.22,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515