No office rate
Use 23410 for an acute cuff rupture and 23412 for a chronic rupture. Documentation should support the clinical classification rather than relying on the code number alone.
On this page
CMS RVU26D · Effective 2026-10-01
23410 Rotator cuff repair Medicare reimbursement rates in Maine
Reports open surgical repair of an acute rotator cuff rupture, with selection based on the tear’s acute presentation and operative findings. Compare 23410 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 23410 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
$710.48–$733.68
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 23410: Acute rotator cuff tendon repair
Reports open surgical repair of an acute rotator cuff rupture, with selection based on the tear’s acute presentation and operative findings.
An orthopedic surgeon uses this code for open repair of an acutely ruptured rotator cuff, reattaching torn tendon tissue to the humerus as needed to restore the cuff. The procedure is generally performed in an operating room, most often in a hospital or ambulatory surgery center. The operative report should describe the acute tear and the repair performed.
Choose this code for an acute rupture rather than the chronic-tear repair code; document the clinical history and operative findings that support the acute classification. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same 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%. Assistant-at-surgery services may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 23410
- 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 RVU11.11 · 49%
- Practice expense (office) RVU9.49 · 41%
- Malpractice RVU2.30 · 10%
3.5K
Medicare services in 2024 · #2075 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.
23410 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
Use 23410 for open repair of an acute cuff rupture; 29827 describes arthroscopic rotator cuff repair.
No office rate
23420 is for reconstruction of a chronic, complete cuff avulsion, not the acute cuff repair described by 23410.
Compare 23410 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
$710.48
Southern Maine →
Office / nonfacility
Unavailable
Facility
$733.68
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23410 billing questions
How does 23410 differ from 23412?
23410 is for repair of an acute rotator cuff rupture; 23412 is for a chronic rupture. Use the clinical history and operative findings to support the acute-versus-chronic choice.
Is 23410 the code for arthroscopic cuff repair?
No. 23410 describes open repair. CPT 29827 is the arthroscopic rotator cuff repair code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through 90 days after surgery.
How is bilateral repair reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
2,19523400,,Fixation of shoulder blade,A,,13.52,10.50,NA,10.50,,2.89,26.91,26.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19623405,,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