No office rate
Both address a benign lesion in the scapula, but 23146 is distinguished by use of allograft. Select the code that matches the graft approach documented in the operative report.
On this page
CMS RVU26D · Effective 2026-10-01
23146 Bone lesion removal Medicare reimbursement rates in Iowa
Reports surgical curettage or excision of a benign bone lesion in the scapula when the resulting defect is filled with donor bone graft. Compare 23146 office and facility rates across CMS payment localities in Iowa.
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 23146 in Iowa?
Iowa 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
$538.83
1 of 1 localities have a supported rate.
Payment area: Iowa
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 23146: Scapular bone lesion curettage with allograft
Reports surgical curettage or excision of a benign bone lesion in the scapula when the resulting defect is filled with donor bone graft.
An orthopedic surgeon removes or curettes a benign bone cyst or tumor in the scapula and fills the resulting bone defect with allograft. The service is performed in an operative setting when the lesion requires surgical treatment; it is distinct from removing a lesion in the clavicle or humerus. The allograft is the differentiating feature of this scapular lesion procedure.
Select the code when the operative report supports the scapular site, removal or curettage of a benign lesion, and placement of allograft. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 23146
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.88 · 44%
- Practice expense (office) RVU8.29 · 46%
- Malpractice RVU1.68 · 9%
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.
23146 compared with similar codes
Office rates for Iowa, from the same CMS release.
Compare 23146 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
Iowa →
Office / nonfacility
Unavailable
Facility
$538.83
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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 23146 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,173
- Code
- 23146
- Physician work
- 7.88
- Practice expense
- 8.29
- Malpractice
- 1.68
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.88 | × 1.000 | 7.8800 |
| Practice expense | 8.29 | × 0.915 | 7.5853 |
| Malpractice | 1.68 | × 0.397 | 0.6670 |
| Total RVUs | 16.1323 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$538.83
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.88 | 1 |
| Practice expense | 8.29 | 0.915 |
| Malpractice | 1.68 | 0.397 |
(7.88 × 1 + 8.29 × 0.915 + 1.68 × 0.397) × $33.4009 = $538.83
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.
23146 billing questions
When should this code be selected instead of 23145?
Use 23146 for a scapular lesion procedure that uses allograft. Code 23145 represents a different graft approach for a scapular lesion.
Does the code cover removal of a humeral lesion?
No. This code is for a lesion in the scapula; humeral lesion procedures are reported from the humerus code series, such as 23150 or 23155.
What documentation supports reporting this code?
The operative report should identify the scapular lesion, describe its removal or curettage, and document use of allograft to fill the bone defect.
How is bilateral reporting handled?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included?
The 90-day global period 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.
2,17023130,,Acromp/acromionectomy prtl,A,,7.58,8.52,NA,8.52,,1.59,17.69,17.69,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17123140,,Removal of bone lesion,A,,6.94,7.50,NA,7.50,,1.47,15.91,15.91,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17223145,,Removal of bone lesion,A,,9.17,8.55,NA,8.55,,1.95,19.67,19.67,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17323146,,Removal of bone lesion,A,,7.88,8.29,NA,8.29,,1.68,17.85,17.85,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17423150,,Removal of humerus lesion,A,,8.69,8.40,NA,8.40,,1.85,18.94,18.94,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17523155,,Removal of humerus lesion,A,,10.59,9.57,NA,9.57,,2.25,22.41,22.41,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17623156,,Removal of humerus lesion,A,,8.88,8.46,NA,8.46,,1.90,19.24,19.24,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136