No office rate
Use 23430 for open fixation of the long-head biceps tendon; 29828 describes arthroscopic tenodesis.
On this page
CMS RVU26D · Effective 2026-10-01
23430 Biceps surgery Medicare reimbursement rates in Massachusetts
Reports open surgical fixation of the long head of the biceps tendon, commonly performed for a painful or damaged tendon during shoulder surgery. Compare 23430 office and facility rates across CMS payment localities in Massachusetts.
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 23430 in Massachusetts?
Massachusetts 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
$704.04–$760.61
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.
Shoulder surgery
About 23430: Open long-head biceps tendon fixation
Reports open surgical fixation of the long head of the biceps tendon, commonly performed for a painful or damaged tendon during shoulder surgery.
An orthopedic surgeon releases the long head of the biceps tendon from its shoulder attachment and secures it to the humerus through an open approach. The operation is commonly performed in an operating room for a diseased, unstable, or ruptured tendon causing shoulder symptoms. It may be performed as a standalone procedure or during a shoulder operation such as repair of a rotator cuff tear.
Report this code for the open tendon-fixation procedure, not for arthroscopic-only fixation or simple tendon release. The operative report should identify the long-head tendon, describe the open fixation and its site, and clarify any other procedures performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one 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 23430
- 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 RVU9.92 · 48%
- Practice expense (office) RVU8.94 · 43%
- Malpractice RVU1.99 · 10%
41.3K
Medicare services in 2024 · #858 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.
23430 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
23430 fixes the tendon to another site. 23440 is used when the long-head tendon is released without fixation.
No office rate
23412 addresses repair of a chronic rotator cuff tear, not fixation of the long-head biceps tendon. Both procedures may be performed in one operation.
Compare 23430 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
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$760.61
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$704.04
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23430 billing questions
How does this code differ from arthroscopic biceps tenodesis?
This code describes open fixation of the long-head biceps tendon. For fixation performed arthroscopically, consider 29828 instead.
When is tendon release reported instead of fixation?
A release without securing the tendon elsewhere is a tenotomy, not a tenodesis. The long-head biceps tenotomy code is 23440.
Can this be reported with a rotator cuff repair?
It may be performed during the same shoulder operation as a rotator cuff repair. Document the separate tendon condition and the work performed; multiple-procedure payment reduction may apply.
What documentation supports this code?
Document the affected long-head tendon, the reason for surgery, the open approach, and how and where the tendon was secured. Include the distinct work when another shoulder procedure is performed.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
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.
2,19923412,,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
2,20323440,,Remove/transplant tendon,A,,10.37,8.46,NA,8.46,,2.17,21.00,21.00,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20423450,,Repair shoulder capsule,A,,13.36,9.89,NA,9.89,,2.85,26.10,26.10,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20523455,,Repair shoulder capsule,A,,14.30,9.33,NA,9.33,,2.73,26.36,26.36,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00