$470.86–$523.55
23030 addresses a deep shoulder or axillary soft-tissue abscess or hematoma. Choose 23035 when the operative work includes incision of the shoulder-area bone cortex.
On this page
CMS RVU26D · Effective 2026-10-01
23035 Bone incision Medicare reimbursement rates in Florida
Reports an operative incision through shoulder-area bone cortex, typically to treat or investigate osteomyelitis or a bone abscess. Compare 23035 office and facility rates across CMS payment localities in Florida.
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 23035 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$653.44–$739.86
3 of 3 localities have a supported rate.
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.
Where 23035 pays more and less in Florida
Orthopedic surgery
About 23035: Shoulder-area bone cortex incision
Reports an operative incision through shoulder-area bone cortex, typically to treat or investigate osteomyelitis or a bone abscess.
An orthopedic surgeon uses this service when the operative target is bone in the shoulder area and the cortex must be incised, such as to address osteomyelitis or a bone abscess. The work is performed in an operative setting; it is distinct from opening a deep shoulder soft-tissue abscess or an infected bursa when the bone cortex is not the target.
Report the code when the operative note identifies the shoulder-area bone and documents the cortical incision and its purpose. This major surgery code includes 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 23035
- 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 RVU8.93 · 47%
- Practice expense (office) RVU8.23 · 43%
- Malpractice RVU1.84 · 10%
135
Medicare services in 2024 · #4635 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.
23035 compared with similar codes
Office rates for Florida, from the same CMS release.
$458.89–$508.61
23031 is for drainage of an infected shoulder bursa. This code is for a cortical incision in shoulder-area bone.
$230.97–$255.29
23065 describes biopsy of superficial shoulder-area tissue. This code concerns an incision through bone cortex, not a superficial soft-tissue biopsy.
$621.04–$691.23
23066 describes biopsy of deep shoulder-area tissue. Select this code when the documented service is incision of bone cortex instead.
Compare 23035 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.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
Unavailable
Facility
$687.85
Miami →
Office / nonfacility
Unavailable
Facility
$739.86
Rest Of Florida →
Office / nonfacility
Unavailable
Facility
$653.44
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23035 billing questions
How does this differ from 23030?
Use 23035 when the surgeon incises the shoulder-area bone cortex. Code 23030 describes drainage of a deep abscess or hematoma in shoulder or axillary soft tissue.
Is an infected shoulder bursa reported with this code?
When the operative target is an infected bursa, 23031 describes that service. This code is for incision of bone cortex, not bursal drainage.
What should the operative note document?
Document the shoulder-area bone treated, the cortical incision, and the clinical purpose, such as treatment of osteomyelitis or a bone abscess.
Can modifier 50 be used for bilateral procedures?
Yes. CMS payment for bilateral reporting with modifier 50 is 150%.
What global and assistant-surgery rules apply?
The code has a 90-day global period that includes the day-before preoperative visit and related postoperative care. An assistant at surgery may be paid, but 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 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.
2,14923020,,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
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