Billing code 23156: Bone lesion surgeryMedicare rate & RVUs in Delaware
Reports excision or curettage of a humeral bone cyst or benign tumor when the surgeon fills the resulting defect with allograft.
CMS doesn’t publish an office rate for 23156 in Delaware.
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 23156 covers
An orthopedic surgeon typically performs this open procedure in an operating room to remove or curette a bone cyst or benign tumor in the humerus and fill the resulting defect with donor bone graft. The treatment may address a lesion in the upper arm bone that needs surgical removal and graft reconstruction; the operative report should identify the humeral site, lesion, removal method, and use of allograft.
Choose this code when the humeral lesion is treated by excision or curettage with allograft, rather than selecting a code for a different graft method or no graft. The 90-day global period includes 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. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; 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.
23156 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $634.32 |
How the 23156 rate is calculated
Each of 23156’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 · 23156
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.88Practice expense 8.46Malpractice 1.90
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23156
23156 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23156
Bone lesion surgery
| 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) | 2 | Paid. |
| 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 · 23156
Bone lesion surgery
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
23156 without 50 · national facility
$642.63
Bone lesion surgery
23156-50 · Bilateral: 150%
$963.95
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).
23156 compared with similar codes
Compare codes
23156 vs 23150 vs 23155 vs 23184: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23150Bone lesion removal
- Use 23156 when the humeral cyst or benign tumor is excised or curetted and the defect is filled with allograft. Use 23150 for the corresponding service without graft.
- 23155Bone lesion excision
- Both describe humeral lesion treatment with grafting, but 23155 specifies autograft and 23156 specifies allograft.
- 23184Bone excision
- 23184 describes partial excision of proximal humerus. Choose 23156 for curettage or excision of a bone cyst or benign tumor with allograft.
23156 billing questions
How does 23156 differ from 23150?
23156 describes humeral cyst or benign-tumor excision or curettage with allograft. 23150 is the corresponding humeral service without graft.
How does 23156 differ from 23155?
The distinction is the graft source: 23156 uses allograft, while 23155 uses autograft.
Is the allograft part of the reported service?
Yes. Allograft use is the distinguishing feature of 23156; do not also report 23150 for the same lesion treatment.
What documentation supports reporting 23156?
Document the humeral lesion and its location, the excision or curettage performed, and that allograft was used to fill the defect.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
Can 23156 be reported for bilateral humeral lesions?
For bilateral treatment, modifier 50 is paid at 150% under the CMS facts for this code.
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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