No office rate
The operative site and lesion treatment are comparable, but 23146 is the allograft option. Code 23145 describes reconstruction with the patient’s own bone.
On this page
CMS RVU26D · Effective 2026-10-01
23145 Bone lesion removal Medicare reimbursement rates in Maine
Reports operative curettage or excision of a benign bone cyst or tumor in the scapula when the defect is reconstructed with the patient’s own bone. Compare 23145 office and facility rates across CMS payment localities in Maine.
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 23145 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$609.53–$630.39
2 of 2 localities have a supported rate.
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 23145: Scapular bone lesion curettage with autograft
Reports operative curettage or excision of a benign bone cyst or tumor in the scapula when the defect is reconstructed with the patient’s own bone.
An orthopedic surgeon, often an orthopedic oncologist, uses this service to remove or curette a benign cystic or tumorous lesion in the scapula and fill the resulting defect with autologous bone graft. The work includes obtaining the patient’s graft as part of the procedure. It is a surgical treatment of a scapular lesion, not simply an arthrotomy for joint inspection or biopsy.
Report the code when the operative record supports the scapular site, lesion removal by curettage or excision, and use of the patient’s own bone graft. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one 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-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 23145
- 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 RVU9.17 · 47%
- Practice expense (office) RVU8.55 · 43%
- Malpractice RVU1.95 · 10%
28
Medicare services in 2024 · #5700 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.
23145 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
This neighboring lesion-removal code concerns the clavicle. Use 23145 when the treated lesion is in the scapula and autograft is used.
No office rate
This code concerns a benign lesion of the proximal humerus rather than the scapula. Select by the documented bone site.
Compare 23145 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$609.53
Southern Maine →
Office / nonfacility
Unavailable
Facility
$630.39
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
23145 billing questions
When is 23145 different from 23146?
Both concern benign bone lesions of the scapula, but 23145 involves the patient’s own bone graft. Use 23146 for the allograft approach.
Can the graft-harvesting work be reported separately?
The autograft service includes obtaining the patient’s bone for the reconstruction. Do not separately report graft harvesting as though it were outside this procedure.
What documentation supports this code?
Document the scapular lesion, its removal by excision or curettage, and reconstruction with autologous bone graft. The operative note should make the graft type clear.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The code’s global package applies to care related to this operation.
Can modifier 50 be used for bilateral work?
CMS identifies this as a bilateral procedure; when reported with modifier 50, payment is at 150%. The record should support treatment on both sides.
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.
2,16923125,,Claviculectomy total,A,,9.40,8.63,NA,8.63,,2.00,20.03,20.03,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17023130,,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