$527.20
Both concern a shoulder dislocation with a greater tuberosity fracture. Choose 23670 for open treatment and 23665 for closed treatment.
On this page
CMS RVU26D · Effective 2026-10-01
23670 Shoulder surgery Medicare reimbursement rates in Guam
Reports open treatment of a shoulder dislocation accompanied by a greater tuberosity fracture, including internal fixation when performed. Compare 23670 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 23670 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
$827.93
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 23670: Open shoulder dislocation treatment with tuberosity fracture
Reports open treatment of a shoulder dislocation accompanied by a greater tuberosity fracture, including internal fixation when performed.
An orthopedic surgeon uses an open approach to treat a shoulder joint dislocation associated with a fracture of the humeral greater tuberosity. The operation addresses the dislocation and the associated fracture; internal fixation is included when performed. This service is generally performed in an operating room for a traumatic injury requiring open treatment, rather than closed reduction alone.
Choose this code when the operative record supports both the shoulder dislocation and the greater tuberosity fracture, and documents open treatment. Record the fracture location, the work performed to treat the dislocation and fracture, and any fixation used. CMS classifies the procedure as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. For bilateral procedures reported with modifier 50, payment is 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 23670
- 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 RVU11.97 · 49%
- Practice expense (office) RVU9.99 · 41%
- Malpractice RVU2.52 · 10%
136
Medicare services in 2024 · #4624 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.
23670 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
Code 23660 is open treatment of an acute shoulder dislocation without the greater tuberosity fracture combination covered by 23670.
No office rate
Both describe open treatment of a shoulder dislocation with an associated fracture; 23680 is for a surgical neck fracture rather than a greater tuberosity fracture.
Compare 23670 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
$827.93
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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 23670 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,243
- Code
- 23670
- Physician work
- 11.97
- Practice expense
- 9.99
- Malpractice
- 2.52
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.97 | × 1.000 | 11.9700 |
| Practice expense | 9.99 | × 1.137 | 11.3586 |
| Malpractice | 2.52 | × 0.579 | 1.4591 |
| Total RVUs | 24.7877 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$827.93
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.97 | 1 |
| Practice expense | 9.99 | 1.137 |
| Malpractice | 2.52 | 0.579 |
(11.97 × 1 + 9.99 × 1.137 + 2.52 × 0.579) × $33.4009 = $827.93
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.
23670 billing questions
When should this code be chosen over 23665?
Use 23670 for open treatment of the shoulder dislocation with an associated greater tuberosity fracture. Code 23665 describes closed treatment of that injury pattern.
Is internal fixation separately reported?
Internal fixation, when performed as part of this open treatment, is included in the service. Document the fixation in the operative report.
How does this differ from 23660?
Code 23670 includes an associated greater tuberosity fracture. Code 23660 is for open treatment of an acute shoulder dislocation without that fracture combination.
What documentation supports reporting 23670?
The operative report should identify the shoulder dislocation and greater tuberosity fracture, describe the open treatment of both, and record any fixation performed.
How does the 90-day global affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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 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.
2,24023655,,Cltx sho dslc w/mnpj w/anes,A,,4.64,6.88,NA,6.88,,1.02,12.54,12.54,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24123660,,Optx acute shoulder dislc,A,,7.47,7.55,NA,7.55,,1.48,16.50,16.50,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24223665,,Cltx sho dslc fx gr hmrl tbr,A,,4.54,9.38,,6.93,,1.00,14.92,12.47,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24323670,,Optx sho dislc fx,A,,11.97,9.99,NA,9.99,,2.52,24.48,24.48,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24423675,,Cltx sho dislc neck fx mnpj,A,,6.11,11.40,,7.86,,1.33,18.84,15.30,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24523680,,Optx sho dislc neck fx fixj,A,,12.82,10.35,NA,10.35,,2.73,25.90,25.90,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24623700,,Mnpj anes sho jt fixj aprats,A,,2.51,2.53,NA,2.53,,0.49,5.53,5.53,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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