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CMS RVU26D · Effective 2026-10-01

23935 Bone drainage Medicare reimbursement rates in Kentucky

Reports deep operative drainage involving the humerus or elbow when the surgeon opens the bone cortex to reach and drain the affected site. Compare 23935 office and facility rates across CMS payment localities in Kentucky.

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 23935 in Kentucky?

Kentucky 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

$464.54

1 of 1 localities have a supported rate.

Payment area: Kentucky

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 23935 in your payment locality →

Orthopedic surgery

About 23935: Deep bone drainage, humerus or elbow

Reports deep operative drainage involving the humerus or elbow when the surgeon opens the bone cortex to reach and drain the affected site.

This service involves a deep incision to reach the humerus or elbow and opening the bone cortex to drain an affected site, such as a bone abscess. It is typically performed by an orthopedic surgeon in an operating room when the infection or collection requires access through the cortex rather than drainage of a superficial or soft-tissue space.

Select 23935 when the operative work includes opening the cortex of the humerus or elbow; the operative report should identify the anatomic site, the deep collection or bone involvement, and the cortical opening and drainage performed. CMS classifies the service as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 23935

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 RVU6.22 · 42%
  • Practice expense (office) RVU7.31 · 49%
  • Malpractice RVU1.30 · 9%

123

Medicare services in 2024 · #4712 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.

23935 compared with similar codes

Office rates for Kentucky, from the same CMS release.

23930

Deep drainage

Upper arm or elbow

$350.16

23930 describes deep drainage in the upper arm or elbow area. Choose 23935 when the operative service includes opening the humerus or elbow cortex.

23931

Bursal drainage

Upper arm or elbow

$294.97

23931 is for drainage of an upper-arm or elbow bursa; 23935 involves a deep site reached by opening bone cortex.

23035

Bone incision

Shoulder area

No office rate

Both involve deep drainage with cortical opening, but 23035 is for the shoulder area; 23935 is for the humerus or elbow.

Compare 23935 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

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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 23935 in Kentucky.

PPRRVU2026_Oct_nonQPP.csv

2,255

Code
23935
Physician work
6.22
Practice expense
7.31
Malpractice
1.30

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Facility calculation for 23935 in Kentucky
ComponentRVULocality factorAdjusted
Physician work6.22× 1.0006.2200
Practice expense7.31× 0.8896.4986
Malpractice1.30× 0.9151.1895
Total RVUs13.9081
Conversion factor× 33.4009

Facility rate, Kentucky$464.54

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
Work6.221
Practice expense7.310.889
Malpractice1.30.915

(6.22 × 1 + 7.31 × 0.889 + 1.3 × 0.915) × $33.4009 = $464.54

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.

23935 billing questions

When should I choose 23935 instead of 23930?

Use 23935 when the surgeon opens the bone cortex of the humerus or elbow to drain the deep site. Code 23930 describes deep drainage in the upper arm or elbow area without that cortical opening.

How is 23935 different from drainage of an elbow bursa?

23935 involves opening the humerus or elbow cortex. Use 23931 when the operative target is an upper-arm or elbow bursa.

What documentation supports 23935?

The operative report should identify the humerus or elbow site and describe the deep approach, cortical opening, and drainage performed.

What does the 90-day global period include?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can 23935 be reported bilaterally?

For a bilateral procedure, CMS pays the service with modifier 50 at 150%.

When can an assistant surgeon be paid?

Assistant-at-surgery payment is allowed only when medical necessity is documented. CMS does not permit co-surgeons or team surgery for this code.

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 23935PPRRVU2026_Oct_nonQPP.csv, line 2,255 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet