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CMS RVU26D · Effective 2026-10-01

23802 Shoulder fusion Medicare reimbursement rates in Indiana

Reports surgical fusion of the shoulder’s glenohumeral joint using bone graft, typically as a salvage procedure for a painful or unstable shoulder. Compare 23802 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 23802 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

$1083.45

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.

Find 23802 in your payment locality →

Orthopedic surgery

About 23802: Glenohumeral fusion with bone graft

Reports surgical fusion of the shoulder’s glenohumeral joint using bone graft, typically as a salvage procedure for a painful or unstable shoulder.

An orthopedic surgeon fuses the humeral head to the glenoid with fixation and bone graft to create a stable shoulder. This is a salvage operation for situations such as a painful, unstable shoulder after failed reconstruction or when joint replacement is unsuitable. The procedure is performed in an operating room, with graft placement supporting bony union across the joint.

Report this code when the operative record supports glenohumeral arthrodesis with bone graft; use the no-graft sibling code when the fusion is performed without graft. Document the joint fused, graft use, fixation, and clinical reason for fusion. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 23802

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 RVU17.96 · 51%
  • Practice expense (office) RVU13.61 · 38%
  • Malpractice RVU3.83 · 11%

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.

23802 compared with similar codes

Office rates for Indiana, from the same CMS release.

23800

Shoulder fusion

Without bone graft

No office rate

Both codes describe glenohumeral arthrodesis; select 23802 when bone graft is used and 23800 when it is not.

23472

Shoulder arthroplasty

Primary, both joint surfaces

No office rate

23472 describes total shoulder joint replacement. This code describes fusion of the glenohumeral joint with bone graft.

23470

Shoulder arthroplasty

Hemiarthroplasty

No office rate

23470 describes shoulder hemiarthroplasty, while this code is for fusing the glenohumeral joint with bone graft.

Compare 23802 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

Office and facility base rates · shared scale starting at $0
  • Indiana →

    Office / nonfacility

    Unavailable

    Facility

    $1083.45

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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 23802 in Indiana.

PPRRVU2026_Oct_nonQPP.csv

2,248

Code
23802
Physician work
17.96
Practice expense
13.61
Malpractice
3.83

GPCI2026.csv

52

Locality
Indiana
Physician work
1.000
Practice expense
0.927
Malpractice
0.486
Facility calculation for 23802 in Indiana
ComponentRVULocality factorAdjusted
Physician work17.96× 1.00017.9600
Practice expense13.61× 0.92712.6165
Malpractice3.83× 0.4861.8614
Total RVUs32.4378
Conversion factor× 33.4009

Facility rate, Indiana$1083.45

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work17.961
Practice expense13.610.927
Malpractice3.830.486

(17.96 × 1 + 13.61 × 0.927 + 3.83 × 0.486) × $33.4009 = $1083.45

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.

23802 billing questions

When should I report this instead of 23800?

Report 23802 when the glenohumeral fusion includes bone graft. Use 23800 for the fusion without graft.

Can the bone graft harvest be billed separately?

The graft is part of this grafted arthrodesis service. Do not separately report a graft-harvest service for work included in the procedure.

What documentation supports this code?

The operative report should identify the glenohumeral joint fusion, bone graft use, fixation, and the clinical reason for the salvage procedure.

How are bilateral procedures handled?

CMS pays bilateral reporting with modifier 50 at 150%. Document the procedure on both shoulders.

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.

What postoperative care is included?

The 90-day global 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.

RVUs for 23802PPRRVU2026_Oct_nonQPP.csv, line 2,248 (RVU26D)
Geographic factors for IndianaGPCI2026.csv, line 52 (RVU26D)