No office rate
This is the related shoulder-prosthesis removal code. Distinguish the codes by the complexity and extent documented for the removal.
On this page
CMS RVU26D · Effective 2026-10-01
23334 Prosthesis removal Medicare reimbursement rates in Guam
Report this service when a surgeon removes a prosthetic implant from the shoulder joint, such as during a staged treatment or implant-removal operation. Compare 23334 office and facility rates across CMS payment localities in Guam.
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 23334 in Guam?
Guam 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
$983.51
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 23334: Shoulder prosthesis removal
Report this service when a surgeon removes a prosthetic implant from the shoulder joint, such as during a staged treatment or implant-removal operation.
The surgeon removes a prosthesis or implant from the shoulder joint, commonly in an operating room when an implant must be explanted, including in staged treatment or before a later reconstruction. The operative report should identify the shoulder, the prosthetic components removed, the reason for removal, and the work performed. Removal of a prosthesis is distinct from taking out a nonprosthetic foreign body in the shoulder region.
Select this code when the documented service is removal of the shoulder prosthesis; use the applicable sibling or revision code when the operation’s extent supports that choice. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 23334
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.11 · 52%
- Practice expense (office) RVU11.05 · 38%
- Malpractice RVU3.06 · 10%
174
Medicare services in 2024 · #4448 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.
23334 compared with similar codes
Office rates for Guam, from the same CMS release.
$357.39
This code concerns removal of a shoulder foreign body, not removal of a shoulder joint prosthesis.
No office rate
This code concerns removal of a deep shoulder foreign body, not removal of a shoulder joint prosthesis.
Compare 23334 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$983.51
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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 23334 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,190
- Code
- 23334
- Physician work
- 15.11
- Practice expense
- 11.05
- Malpractice
- 3.06
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.11 | × 1.000 | 15.1100 |
| Practice expense | 11.05 | × 1.137 | 12.5639 |
| Malpractice | 3.06 | × 0.579 | 1.7717 |
| Total RVUs | 29.4456 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$983.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.11 | 1 |
| Practice expense | 11.05 | 1.137 |
| Malpractice | 3.06 | 0.579 |
(15.11 × 1 + 11.05 × 1.137 + 3.06 × 0.579) × $33.4009 = $983.51
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.
23334 billing questions
How does this differ from 23335?
Both concern shoulder prosthesis removal. Choose the sibling that matches the documented complexity and operative work; the operative report should support that distinction.
Can this be reported with a shoulder revision arthroplasty?
When removal is part of a same-session revision, code selection should reflect the revision procedure performed. Do not report isolated prosthesis removal automatically for work included in the revision.
What documentation supports this code?
Document the shoulder involved, the prosthesis or components removed, the indication, and the operative work. State whether the procedure was unilateral or bilateral.
How does Medicare handle bilateral reporting?
For bilateral shoulder prosthesis removal, report modifier 50; CMS pays the bilateral procedure at 150%.
Is an assistant surgeon payable for this procedure?
CMS applies a statutory restriction, so an assistant at surgery is not paid. Co-surgeons are paid only when supporting documentation is provided.
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.
2,18723220,,Radical rescj tumor prox hum,A,,29.45,16.31,NA,16.31,,6.26,52.02,52.02,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18823330,,Remove shoulder foreign body,A,,1.85,7.58,,2.73,,0.40,9.83,4.98,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18923333,,Remove shoulder fb deep,A,,5.85,6.66,NA,6.66,,1.25,13.76,13.76,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19023334,,Shoulder prosthesis removal,A,,15.11,11.05,NA,11.05,,3.06,29.22,29.22,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19123335,,Shoulder prosthesis removal,A,,18.53,12.10,NA,12.10,,3.75,34.38,34.38,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19223350,,Injection for shoulder x-ray,A,,0.98,3.63,,0.19,,0.09,4.70,1.26,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19323395,,Muscle transfer shoulder/arm,A,,18.08,13.46,NA,13.46,,3.72,35.26,35.26,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014