CPT code 23066: Shoulder biopsy2026 Medicare rate & RVUs in Alaska
Report this code for operative biopsy sampling of deep soft tissue in the shoulder area when tissue is obtained for diagnostic evaluation.
Medicare pays $711.35 for 23066 in the office in Alaska (Alaska*). Which amount applies depends on the service address.
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 9 sections
What 23066 covers
This code represents operative sampling of deep soft tissue in the shoulder area for diagnostic evaluation, such as assessment of an indeterminate mass or other abnormal tissue. An orthopedic surgeon or other surgeon exposes the target tissue and removes a specimen for examination. It is distinct from a superficial shoulder-tissue biopsy and from an operation that removes the entire lesion. The service is generally performed in an operating room or other surgical setting.
Select the code based on the documented depth and the fact that tissue was sampled rather than the full lesion excised. The operative report should identify the shoulder site, the deep tissue sampled, and the biopsy performed. This major surgery has a 90-day global period, including 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are 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.
23066 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | $711.35 | $435.31 |
How the 23066 rate is calculated
Each of 23066’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 · 23066
RVUs × geographic indexes × conversion factor
Work4.19
4.19 RVUs× 1.000 GPCI
Practice expense13.62
13.62 RVUs× 1.000 GPCI
Malpractice0.92
0.92 RVUs× 1.000 GPCI
Adjusted RVUs
18.7300
Conversion factor
$33.4009
Medicare rate
$625.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23066
23066 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23066
Shoulder biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 23066
Shoulder biopsy
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
23066 without 50 · national office
$625.60
Shoulder biopsy
23066-50 · Bilateral: 150%
$938.40
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).
23066 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23065Shoulder biopsy
- 23065 is for superficial shoulder-area tissue. Choose 23066 when the sampled tissue is documented as deep.
- 23076Shoulder tumor excision
- 23076 describes excision of a deep shoulder tumor smaller than 5 cm. Use 23066 when the operation samples tissue rather than removing the lesion.
- 23073Shoulder tumor excision
- 23073 describes excision of a deep shoulder tumor 5 cm or larger. A diagnostic sample without removal of the full lesion points to 23066.
23066 billing questions
How does this differ from 23065?
23066 is for biopsy of deep shoulder-area tissue; 23065 is the superficial-tissue sibling. The operative documentation should support the depth selected.
When should an excision code be considered instead?
Use an applicable shoulder-lesion excision code when the operation removes the lesion rather than taking a diagnostic sample. Deep excision codes are selected in part by lesion size.
Is the pathologist's examination included?
This code represents the surgeon's operative tissue sampling. A pathologist's examination is a distinct service when performed and appropriately reported.
What is included in the global period?
The 90-day global includes the related preoperative visit on the day before surgery and related postoperative care for 90 days.
How are bilateral biopsies and other same-session procedures handled?
Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
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 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
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