Billing code 23472: Shoulder arthroplastyMedicare rate & RVUs in Florida
Report this service for primary total shoulder arthroplasty replacing both the humeral and glenoid surfaces, including conventional or reverse-design constructs.
CMS doesn’t publish an office rate for 23472 in Florida.
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 23472 covers
An orthopedic surgeon replaces the humeral and glenoid surfaces of the shoulder’s glenohumeral joint with prosthetic components. The procedure is performed in an operating room, commonly for advanced shoulder arthritis or other joint damage when total replacement is chosen. Both conventional and reverse-design total shoulder constructs are reported with this code; the operative report should identify the replacement performed and the components implanted.
Report the primary total replacement, rather than a humeral-side-only replacement or a revision procedure. Documentation should support the condition treated, the operative approach, and replacement of both joint surfaces. 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 one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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.
Where 23472 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $1,423.60 |
| Miami | Unavailable | $1,540.75 |
| Rest Of Florida | Unavailable | $1,354.46 |
How the 23472 rate is calculated
Each of 23472’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 · 23472
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.58Practice expense 12.99Malpractice 4.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23472
23472 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23472
Shoulder arthroplasty
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 23472
Shoulder arthroplasty
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
23472 without 50 · national facility
$1,300.30
Shoulder arthroplasty
23472-50 · Bilateral: 150%
$1,950.45
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).
23472 compared with similar codes
Compare codes
23472 vs 23470 vs 23473 vs 23474 vs 23412: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23470Shoulder arthroplasty
- Choose 23472 when both humeral and glenoid surfaces are replaced. Choose 23470 for replacement limited to the humeral side.
- 23473Shoulder revision
- 23473 describes revision of one component of an existing shoulder prosthesis; 23472 describes primary total replacement.
- 23474Shoulder revision
- 23474 is for revision of both components of an existing shoulder prosthesis. Use 23472 for primary replacement of both joint surfaces.
- 23412Rotator cuff repair
- 23412 repairs a chronic rotator cuff tear rather than replacing the glenohumeral joint surfaces.
23472 billing questions
How does this differ from 23470?
Code 23472 represents replacement of both the humeral and glenoid surfaces. Code 23470 represents replacement on the humeral side without glenoid replacement.
Which code applies when a shoulder prosthesis is revised?
Use 23473 for revision of one component and 23474 when both components are revised. Code 23472 describes a primary total replacement, not revision of an existing prosthesis.
Does the code include both prosthetic components?
Yes. The service is the total shoulder replacement of the humeral and glenoid surfaces; it is not reported as separate replacement codes for each surface.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is this paid when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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 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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