No office rate
23490 is the corresponding prophylactic stabilization service for the clavicle. This code is for the scapula.
On this page
CMS RVU26D · Effective 2026-10-01
23491 Scapular stabilization Medicare reimbursement rates in Florida
Reports operative stabilization of a structurally weakened scapula to reduce fracture risk, commonly when a bone lesion threatens the bone’s integrity. Compare 23491 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 23491 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
$972.33–$1106.68
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 23491 pays more and less in Florida
Orthopedic surgery
About 23491: Prophylactic scapular stabilization
Reports operative stabilization of a structurally weakened scapula to reduce fracture risk, commonly when a bone lesion threatens the bone’s integrity.
This service stabilizes a scapula at risk of fracturing before a fracture occurs. The surgeon reinforces the bone with fixation such as a plate, pins, or wires, with or without bone cement. A typical setting is a hospital operating room, and the procedure may be performed by an orthopedic surgeon, including an orthopedic oncologist, when a lesion has substantially weakened the scapula. The operative note should identify the scapular site, the structural concern and fracture risk, and the stabilization performed.
Report the service for preventive reinforcement, not simply because a scapular lesion is present or because an established fracture is being repaired. Document the indication, laterality, fixation method, and any cement use. CMS 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 the 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.
CMS billing rules for 23491
- 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 RVU14.18 · 51%
- Practice expense (office) RVU10.87 · 39%
- Malpractice RVU3.02 · 11%
93
Medicare services in 2024 · #4930 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.
23491 compared with similar codes
Office rates for Florida, from the same CMS release.
No office rate
23150 addresses curettage or excision of a benign scapular bone lesion; this code addresses preventive reinforcement when the bone is at fracture risk.
No office rate
23155 describes resection of a scapular tumor. Choose this code for prophylactic stabilization, not tumor removal itself.
Compare 23491 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
$1023.79
Miami →
Office / nonfacility
Unavailable
Facility
$1106.68
Rest Of Florida →
Office / nonfacility
Unavailable
Facility
$972.33
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23491 billing questions
When is this code appropriate instead of 23490?
Use this code for prophylactic stabilization of the scapula. Code 23490 describes the analogous preventive stabilization of the clavicle.
Is this for a scapular fracture that has already occurred?
It describes preventive reinforcement when the scapula is at risk of fracture. A procedure treating an existing fracture requires the applicable fracture-treatment code instead.
Can removal of the bone lesion also be reported?
A separately performed lesion excision or curettage may be reportable with stabilization. Document each distinct service and check applicable coding edits.
What documentation supports prophylactic stabilization?
Document the scapular site, the lesion or other structural weakness, why fracture risk warrants preventive surgery, and the fixation performed, including laterality and cement use when applicable.
How are bilateral procedures and other same-session procedures paid?
CMS pays bilateral reporting with modifier 50 at 150%. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and other procedures at 50%.
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.
2,21423480,,Revision of collar bone,A,,11.25,9.22,NA,9.22,,2.40,22.87,22.87,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21523485,,Revision of collar bone,A,,13.56,9.77,NA,9.77,,2.76,26.09,26.09,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21623490,,Reinforce clavicle,A,,11.86,9.58,NA,9.58,,2.53,23.97,23.97,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21723491,,Reinforce shoulder bones,A,,14.18,10.87,NA,10.87,,3.02,28.07,28.07,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21823500,,Cltx clavicular fx w/o mnpj,A,,2.15,5.13,,4.74,,0.45,7.73,7.34,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21923505,,Cltx clavicular fx w/mnpj,A,,3.73,7.70,,5.80,,0.81,12.24,10.34,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22023515,,Optx clavicular fx w/int fix,A,,9.45,8.94,NA,8.94,,1.94,20.33,20.33,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00