No office rate
Choose 23040 for open work on the glenohumeral joint; 23044 concerns the acromioclavicular joint.
On this page
CMS RVU26D · Effective 2026-10-01
23040 Shoulder arthrotomy Medicare reimbursement rates in Connecticut
An open operation on the glenohumeral joint for exploration, drainage, or removal of an intra-articular foreign body, typically performed by an orthopedic surgeon. Compare 23040 office and facility rates across CMS payment localities in Connecticut.
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 23040 in Connecticut?
Connecticut 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
$715.45
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 23040: Open glenohumeral joint exploration
An open operation on the glenohumeral joint for exploration, drainage, or removal of an intra-articular foreign body, typically performed by an orthopedic surgeon.
This code describes open entry into the glenohumeral joint to inspect the joint, drain it, or remove a foreign body. An orthopedic surgeon may perform it in a hospital or other surgical facility when the treatment requires open access to the shoulder joint, such as for an intra-articular problem that cannot be managed with needle aspiration or a less invasive approach. It is distinct from procedures directed at the acromioclavicular joint, shoulder bursa, or surrounding soft tissues.
Select the code when the operative report supports open joint entry and identifies the purpose, such as exploration, drainage, or foreign-body removal. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 50% multiple-procedure reduction. For bilateral treatment, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 23040
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.51 · 47%
- Practice expense (office) RVU8.68 · 43%
- Malpractice RVU1.96 · 10%
1K
Medicare services in 2024 · #2939 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.
23040 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$507.13
23030 is for deep shoulder abscess or hematoma drainage. Use 23040 when the operative target is the glenohumeral joint.
$498.09
23031 addresses drainage of an infected shoulder bursa, not open exploration or drainage of the glenohumeral joint.
No office rate
29805 describes diagnostic shoulder arthroscopy. This code is for open entry into the glenohumeral joint for exploration, drainage, or foreign-body removal.
Compare 23040 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
Connecticut →
Office / nonfacility
Unavailable
Facility
$715.45
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 23040 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
2,153
- Code
- 23040
- Physician work
- 9.51
- Practice expense
- 8.68
- Malpractice
- 1.96
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.51 | × 1.020 | 9.7002 |
| Practice expense | 8.68 | × 1.077 | 9.3484 |
| Malpractice | 1.96 | × 1.210 | 2.3716 |
| Total RVUs | 21.4202 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$715.45
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.51 | 1.02 |
| Practice expense | 8.68 | 1.077 |
| Malpractice | 1.96 | 1.21 |
(9.51 × 1.02 + 8.68 × 1.077 + 1.96 × 1.21) × $33.4009 = $715.45
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.
23040 billing questions
How is this code distinguished from 23044?
This code concerns open exploration, drainage, or foreign-body removal in the glenohumeral joint. Code 23044 addresses the acromioclavicular joint.
Can it be reported for drainage of a shoulder abscess?
Use it when the operation enters and treats the glenohumeral joint. Code 23030 is for deep shoulder abscess or hematoma drainage outside that joint.
Does the code describe arthroscopic treatment?
No. It describes an open joint procedure. Diagnostic shoulder arthroscopy is represented by a different code, such as 29805.
What should the operative report document?
Document open entry into the glenohumeral joint and the specific purpose—exploration, drainage, or removal of a foreign body. Identify the treated joint so the service can be distinguished from work on the AC joint, bursa, or surrounding tissues.
How are bilateral procedures and other same-session procedures handled?
Modifier 50 is paid at 150% for bilateral treatment. When other 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.
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.
2,15023030,,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
2,15323040,,Arthrt gh jt expl/drg/rmv fb,A,,9.51,8.68,NA,8.68,,1.96,20.15,20.15,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15423044,,Arthrt ac sc jt exp/rmvl fb,A,,7.40,7.22,NA,7.22,,1.64,16.26,16.26,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15523065,,Biopsy shoulder tissues,A,,2.24,4.34,,1.80,,0.35,6.93,4.39,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15623066,,Biopsy shoulder tissues,A,,4.19,13.62,,5.86,,0.92,18.73,10.97,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808