No office rate
Choose CPT 23020 for operative capsular release by a nonarthroscopic approach; CPT 29825 describes arthroscopic lysis or resection of shoulder adhesions.
On this page
CMS RVU26D · Effective 2026-10-01
23020 Capsular release Medicare reimbursement rates in Colorado
Reports surgical release of a contracted shoulder capsule, commonly for adhesive capsulitis causing persistent restriction of shoulder motion. Compare 23020 office and facility rates across CMS payment localities in Colorado.
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 23020 in Colorado?
Colorado 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
$658.38
1 of 1 localities have a supported rate.
Payment area: Colorado
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 23020: Open shoulder capsular release
Reports surgical release of a contracted shoulder capsule, commonly for adhesive capsulitis causing persistent restriction of shoulder motion.
This code describes operative release of a contracted shoulder joint capsule to improve motion, such as for adhesive capsulitis. An orthopedic surgeon typically performs the procedure in a hospital or ambulatory surgical facility when restricted motion is attributable to capsular tightness and surgical release is selected. It distinguishes an operative capsular release from manipulation alone and from an arthroscopic release.
Report the code when the operative record supports release of the contracted shoulder capsule; document the side, indication, and work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 23020
- 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 may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.13 · 47%
- Practice expense (office) RVU8.44 · 43%
- Malpractice RVU1.91 · 10%
1.5K
Medicare services in 2024 · #2690 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.
23020 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
CPT 23700 is for manipulation of the shoulder joint under anesthesia. CPT 23020 requires surgical release of the contracted capsule.
No office rate
CPT 23450 describes shoulder capsulorrhaphy for stabilization, which tightens or repairs the capsule; CPT 23020 releases a contracted capsule to address restricted motion.
Compare 23020 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
Colorado →
Office / nonfacility
Unavailable
Facility
$658.38
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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 23020 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,149
- Code
- 23020
- Physician work
- 9.13
- Practice expense
- 8.44
- Malpractice
- 1.91
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.13 | × 1.012 | 9.2396 |
| Practice expense | 8.44 | × 1.064 | 8.9802 |
| Malpractice | 1.91 | × 0.781 | 1.4917 |
| Total RVUs | 19.7114 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$658.38
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.13 | 1.012 |
| Practice expense | 8.44 | 1.064 |
| Malpractice | 1.91 | 0.781 |
(9.13 × 1.012 + 8.44 × 1.064 + 1.91 × 0.781) × $33.4009 = $658.38
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.
23020 billing questions
How does this differ from arthroscopic capsular release?
CPT 23020 represents operative release by an approach other than arthroscopy. Use CPT 29825 when the surgeon performs the release arthroscopically.
Can this code be reported for manipulation alone?
No. CPT 23020 describes surgical release of the contracted capsule; manipulation under anesthesia without capsular release is represented by CPT 23700.
What documentation supports reporting CPT 23020?
The operative report should identify the affected shoulder, the capsular contracture and clinical indication, and the release performed.
How is bilateral surgery handled?
For bilateral procedures, report modifier 50; CMS pays this code at 150% under the stated bilateral rule.
Can an assistant surgeon be reported?
Assistant-at-surgery services may be paid for this procedure. Co-surgeons and team surgery are not permitted.
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.
2,14622905,,Rad resect abd tumor 5 cm/>,A,,21.04,11.18,NA,11.18,,4.83,37.05,37.05,0,090,0.09,0.81,0.10,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14722999,,Unlisted px abdomen muscskel,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14823000,,Rmvl sbdltd clcreous dep opn,A,,4.37,12.04,,4.99,,0.70,17.11,10.06,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14923020,,Capsular contracture release,A,,9.13,8.44,NA,8.44,,1.91,19.48,19.48,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15023030,,I&d shoulder deep absc/hmtma,A,,3.38,10.11,,3.22,,0.70,14.19,7.30,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15123031,,I&d shoulder infected bursa,A,,2.72,10.63,,3.17,,0.57,13.92,6.46,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15223035,,Incision bone cortex sho,A,,8.93,8.23,NA,8.23,,1.84,19.00,19.00,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899