No office rate
Both codes describe rotator cuff repair, but 23410 is for an acute tear and 23412 is for a chronic tear. The documentation should establish which circumstance applies.
On this page
CMS RVU26D · Effective 2026-10-01
23412 Rotator cuff repair Medicare reimbursement rates in Kansas
Reports open surgical repair of a chronic rotator cuff tear, with the operative record supporting the tear’s chronic nature and repair performed. Compare 23412 office and facility rates across CMS payment localities in Kansas.
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 23412 in Kansas?
Kansas 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
$720.70
1 of 1 localities have a supported rate.
Payment area: Kansas
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 23412: Chronic rotator cuff repair
Reports open surgical repair of a chronic rotator cuff tear, with the operative record supporting the tear’s chronic nature and repair performed.
An orthopedic surgeon uses this code for open repair of a chronic tear of the rotator cuff, the tendons that help move and stabilize the shoulder. The surgeon exposes the tear, prepares the tendon and attachment site, and repairs the tendon to restore its attachment. This procedure is commonly performed in a hospital or ambulatory surgery center for patients with a longstanding cuff tear that is treated operatively.
Select this code when the operative findings and documentation support a chronic tear, rather than an acute rupture or a more extensive reconstruction of the complete cuff. Document the affected tendon or tendons, tear characteristics, and repair performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 23412
- 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 RVU11.63 · 49%
- Practice expense (office) RVU9.66 · 41%
- Malpractice RVU2.41 · 10%
10K
Medicare services in 2024 · #1463 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.
23412 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
23420 describes reconstruction of a complete shoulder cuff avulsion. Choose 23412 when the surgeon repairs a chronic cuff tear without documenting that more extensive reconstruction.
No office rate
29827 is for arthroscopic rotator cuff repair; 23412 is for open repair of a chronic tear.
Compare 23412 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
Kansas →
Office / nonfacility
Unavailable
Facility
$720.70
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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 23412 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
2,199
- Code
- 23412
- Physician work
- 11.63
- Practice expense
- 9.66
- Malpractice
- 2.41
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.63 | × 1.000 | 11.6300 |
| Practice expense | 9.66 | × 0.904 | 8.7326 |
| Malpractice | 2.41 | × 0.504 | 1.2146 |
| Total RVUs | 21.5773 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$720.70
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.63 | 1 |
| Practice expense | 9.66 | 0.904 |
| Malpractice | 2.41 | 0.504 |
(11.63 × 1 + 9.66 × 0.904 + 2.41 × 0.504) × $33.4009 = $720.70
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.
23412 billing questions
How does this code differ from 23410?
Use 23412 for a chronic rotator cuff tear and 23410 for an acute tear. The operative documentation should support the tear’s chronic or acute nature.
When would 23420 be a better fit?
23420 describes reconstruction of a complete shoulder (rotator) cuff avulsion. Use 23412 for repair of a chronic cuff tear when the documented procedure is not that more extensive reconstruction.
Is this code for an arthroscopic repair?
No. This code represents open repair; arthroscopic rotator cuff repair is reported with 29827.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How is bilateral repair handled?
When the procedure is performed bilaterally and reported with modifier 50, CMS pays 150%.
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.
2,19623405,,Incision of tendon & muscle,A,,8.33,7.31,NA,7.31,,1.56,17.20,17.20,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19723406,,Incise tendon(s) & muscle(s),A,,10.73,7.97,NA,7.97,,1.48,20.18,20.18,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19823410,,Repair rotator cuff acute,A,,11.11,9.49,NA,9.49,,2.30,22.90,22.90,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19923412,,Repair rotator cuff chronic,A,,11.63,9.66,NA,9.66,,2.41,23.70,23.70,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20023415,,Release of shoulder ligament,A,,9.00,8.86,NA,8.86,,1.85,19.71,19.71,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20123420,,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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958