Billing code 23145: Bone lesion removalMedicare rate & RVUs in Illinois
Reports operative curettage or excision of a benign bone cyst or tumor in the scapula when the defect is reconstructed with the patient’s own bone.
CMS doesn’t publish an office rate for 23145 in Illinois.
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 23145 covers
An orthopedic surgeon, often an orthopedic oncologist, uses this service to remove or curette a benign cystic or tumorous lesion in the scapula and fill the resulting defect with autologous bone graft. The work includes obtaining the patient’s graft as part of the procedure. It is a surgical treatment of a scapular lesion, not simply an arthrotomy for joint inspection or biopsy.
Report the code when the operative record supports the scapular site, lesion removal by curettage or excision, and use of the patient’s own bone graft. 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 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 require 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 23145 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $744.91 |
| East St. Louis | Unavailable | $700.19 |
| Rest Of Illinois | Unavailable | $668.82 |
| Suburban Chicago | Unavailable | $717.13 |
How the 23145 rate is calculated
Each of 23145’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 · 23145
RVUs × geographic indexes × conversion factor
Work9.17
9.17 RVUs× 1.000 GPCI
Practice expense8.55
8.55 RVUs× 1.000 GPCI
Malpractice1.95
1.95 RVUs× 1.000 GPCI
Adjusted RVUs
19.6700
Conversion factor
$33.4009
Medicare rate
$657.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23145
23145 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23145
Bone lesion removal
| 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 · 23145
Bone lesion removal
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
23145 without 50 · national facility
$657.00
Bone lesion removal
23145-50 · Bilateral: 150%
$985.50
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).
23145 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23146Bone lesion removal
- The operative site and lesion treatment are comparable, but 23146 is the allograft option. Code 23145 describes reconstruction with the patient’s own bone.
- 23140Bone lesion removal
- This neighboring lesion-removal code concerns the clavicle. Use 23145 when the treated lesion is in the scapula and autograft is used.
- 23150Bone lesion removal
- This code concerns a benign lesion of the proximal humerus rather than the scapula. Select by the documented bone site.
23145 billing questions
When is 23145 different from 23146?
Both concern benign bone lesions of the scapula, but 23145 involves the patient’s own bone graft. Use 23146 for the allograft approach.
Can the graft-harvesting work be reported separately?
The autograft service includes obtaining the patient’s bone for the reconstruction. Do not separately report graft harvesting as though it were outside this procedure.
What documentation supports this code?
Document the scapular lesion, its removal by excision or curettage, and reconstruction with autologous bone graft. The operative note should make the graft type clear.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The code’s global package applies to care related to this operation.
Can modifier 50 be used for bilateral work?
CMS identifies this as a bilateral procedure; when reported with modifier 50, payment is at 150%. The record should support treatment on both sides.
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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