No office rate
Use 23405 for one tendon in the shoulder area; 23406 covers multiple tendons or muscles.
On this page
CMS RVU26D · Effective 2026-10-01
23405 Shoulder tenotomy Medicare reimbursement rates in Arkansas
Reports surgical division of one tendon in the shoulder area, such as a tendon release performed to address shoulder pain or restricted movement. Compare 23405 office and facility rates across CMS payment localities in Arkansas.
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 23405 in Arkansas?
Arkansas 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
$514.80
1 of 1 localities have a supported rate.
Payment area: Arkansas
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 23405: Single-tendon shoulder tenotomy
Reports surgical division of one tendon in the shoulder area, such as a tendon release performed to address shoulder pain or restricted movement.
This procedure surgically divides one tendon in the shoulder area. An orthopedic surgeon or other qualified surgeon may perform it to release a tendon contributing to pain or restricted shoulder motion. A tenotomy may also be part of operative treatment for shoulder tendon disease, including treatment involving the long head of the biceps. The operative report should identify the tendon and describe the division performed.
Report this code when the procedure involves one tendon; the code for multiple tendons or muscles is a distinct choice. Documentation should support the shoulder location, the tendon treated, and the operative work. CMS assigns 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. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 23405
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.33 · 48%
- Practice expense (office) RVU7.31 · 43%
- Malpractice RVU1.56 · 9%
3.6K
Medicare services in 2024 · #2067 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.
23405 compared with similar codes
Office rates for Arkansas, from the same CMS release.
No office rate
23405 represents tendon division. 23430 is used when the biceps tendon is repaired by tenodesis rather than simply divided.
No office rate
23415 addresses release of a shoulder ligament, not division of a tendon.
No office rate
23412 describes repair of a chronic rotator cuff tear. It is not a substitute for reporting a distinct single-tendon division.
Compare 23405 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
Arkansas →
Office / nonfacility
Unavailable
Facility
$514.80
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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 23405 in Arkansas.
PPRRVU2026_Oct_nonQPP.csv
2,196
- Code
- 23405
- Physician work
- 8.33
- Practice expense
- 7.31
- Malpractice
- 1.56
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.33 | × 1.000 | 8.3300 |
| Practice expense | 7.31 | × 0.859 | 6.2793 |
| Malpractice | 1.56 | × 0.515 | 0.8034 |
| Total RVUs | 15.4127 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arkansas$514.80
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.33 | 1 |
| Practice expense | 7.31 | 0.859 |
| Malpractice | 1.56 | 0.515 |
(8.33 × 1 + 7.31 × 0.859 + 1.56 × 0.515) × $33.4009 = $514.80
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.
23405 billing questions
When should I report this instead of 23406?
Report 23405 for division of a single tendon in the shoulder area. The multiple-tendon or muscle procedure is represented by 23406.
Can this code describe a biceps tenotomy?
It may describe surgical division of a single tendon in the shoulder area, including the long head of the biceps. The operative note should identify the tendon and the work performed.
Is modifier 50 appropriate for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate 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.
How are multiple 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.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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.
2,19323395,,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
2,19523400,,Fixation of shoulder blade,A,,13.52,10.50,NA,10.50,,2.89,26.91,26.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19623405,,Incision of tendon & muscle,A,,8.33,7.31,NA,7.31,,1.56,17.20,17.20,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19723406,,Incise tendon(s) & muscle(s),A,,10.73,7.97,NA,7.97,,1.48,20.18,20.18,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19823410,,Repair rotator cuff acute,A,,11.11,9.49,NA,9.49,,2.30,22.90,22.90,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19923412,,Repair rotator cuff chronic,A,,11.63,9.66,NA,9.66,,2.41,23.70,23.70,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541