No office rate
23450 is the Putti-Platt anterior capsular repair. 23455 applies when the anterior repair also includes labral repair.
On this page
CMS RVU26D · Effective 2026-10-01
23450 Shoulder stabilization Medicare reimbursement rates in Indiana
Open anterior shoulder capsular tightening using a Putti-Platt approach is reported for surgical stabilization of recurrent anterior instability when this technique is performed. Compare 23450 office and facility rates across CMS payment localities in Indiana.
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 23450 in Indiana?
Indiana 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
$798.72
1 of 1 localities have a supported rate.
Payment area: Indiana
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 23450: Anterior Putti-Platt shoulder repair
Open anterior shoulder capsular tightening using a Putti-Platt approach is reported for surgical stabilization of recurrent anterior instability when this technique is performed.
This open stabilization procedure tightens the front of the shoulder capsule, classically with tightening or overlap of the subscapularis, to limit recurrent anterior translation. An orthopedic shoulder surgeon typically performs it in an operating room for a patient with recurrent anterior shoulder instability when the Putti-Platt technique is used.
Select the code from the operative technique, not simply the diagnosis of shoulder instability. The operative report should identify the anterior capsular repair, the technique performed, the side, and any separately described labral work. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. For multiple procedures in the same 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-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 23450
- 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 RVU13.36 · 51%
- Practice expense (office) RVU9.89 · 38%
- Malpractice RVU2.85 · 11%
18
Medicare services in 2024 · #5964 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.
23450 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
23460 describes anterior stabilization with a bone-block technique; 23450 is the Putti-Platt capsular tightening approach.
No office rate
23465 is for posterior capsular stabilization, rather than the anterior stabilization represented by 23450.
No office rate
23466 addresses multidirectional capsular instability; 23450 describes the anterior Putti-Platt approach.
Compare 23450 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
Indiana →
Office / nonfacility
Unavailable
Facility
$798.72
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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 23450 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
2,204
- Code
- 23450
- Physician work
- 13.36
- Practice expense
- 9.89
- Malpractice
- 2.85
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.36 | × 1.000 | 13.3600 |
| Practice expense | 9.89 | × 0.927 | 9.1680 |
| Malpractice | 2.85 | × 0.486 | 1.3851 |
| Total RVUs | 23.9131 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$798.72
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.36 | 1 |
| Practice expense | 9.89 | 0.927 |
| Malpractice | 2.85 | 0.486 |
(13.36 × 1 + 9.89 × 0.927 + 2.85 × 0.486) × $33.4009 = $798.72
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.
23450 billing questions
How is 23450 distinguished from 23455?
23450 describes the Putti-Platt anterior capsular stabilization technique. Use 23455 when the anterior capsulorrhaphy includes labral repair.
What operative details support 23450?
The note should document the anterior capsular tightening and identify the Putti-Platt technique, side, and structures addressed. The diagnosis alone does not establish the procedure performed.
Does the 90-day global include postoperative visits?
Related postoperative care during the 90 days after surgery is included, along with the day-before preoperative visit.
How is bilateral 23450 reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral service at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction at 50%.
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.
2,20123420,,Repair of shoulder,A,,13.20,11.17,NA,11.17,,2.77,27.14,27.14,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20223430,,Repair biceps tendon,A,,9.92,8.94,NA,8.94,,1.99,20.85,20.85,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20323440,,Remove/transplant tendon,A,,10.37,8.46,NA,8.46,,2.17,21.00,21.00,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20423450,,Repair shoulder capsule,A,,13.36,9.89,NA,9.89,,2.85,26.10,26.10,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20523455,,Repair shoulder capsule,A,,14.30,9.33,NA,9.33,,2.73,26.36,26.36,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20623460,,Repair shoulder capsule,A,,15.42,11.26,NA,11.26,,3.28,29.96,29.96,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20723462,,Repair shoulder capsule,A,,15.33,10.67,NA,10.67,,3.26,29.26,29.26,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915