No office rate
The distinction is the number of transfers: 23395 describes a single shoulder or upper-arm muscle transfer; 23397 is for multiple transfers.
On this page
CMS RVU26D · Effective 2026-10-01
23397 Muscle transfer Medicare reimbursement rates in Michigan
Reports multiple muscle transfers in the shoulder or upper arm, commonly performed to restore movement when paralysis or nerve injury has impaired function. Compare 23397 office and facility rates across CMS payment localities in Michigan.
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 23397 in Michigan?
Michigan 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
$1024.64–$1109.19
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 23397: Multiple shoulder or upper-arm muscle transfers
Reports multiple muscle transfers in the shoulder or upper arm, commonly performed to restore movement when paralysis or nerve injury has impaired function.
An orthopedic surgeon relocates multiple functioning muscles or muscle-tendon units in the shoulder or upper arm and attaches them to help restore a lost movement. These operations may be considered when paralysis or a nerve injury has left a muscle group unable to perform its usual function. The service is generally performed in a hospital or other surgical facility.
Select this code when the operative report supports multiple transfers in the shoulder or upper arm; a single transfer is distinguished by 23395. Document the donor structures, their new attachments, the operative site, and the functional goal. Medicare assigns 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery services may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 23397
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU16.34 · 52%
- Practice expense (office) RVU11.40 · 37%
- Malpractice RVU3.48 · 11%
109
Medicare services in 2024 · #4812 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.
23397 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
Use 24301 for a muscle transfer at the upper arm or elbow site described by that code. 23397 is the shoulder or upper-arm multiple-transfer code.
No office rate
25310 concerns tendon transfer at the wrist or forearm. 23397 concerns multiple muscle transfers in the shoulder or upper arm.
Compare 23397 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
Detroit →
Office / nonfacility
Unavailable
Facility
$1109.19
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$1024.64
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.
23397 billing questions
How does 23397 differ from 23395?
23397 is for multiple muscle transfers in the shoulder or upper arm. Use 23395 when the operation involves a single transfer.
What documentation supports reporting multiple transfers?
The operative report should identify the transferred muscles or muscle-tendon units, their new attachments, the shoulder or upper-arm site, and the intended functional restoration.
Should modifier 50 be appended for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How is postoperative care handled?
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 services may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
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.
2,19123335,,Shoulder prosthesis removal,A,,18.53,12.10,NA,12.10,,3.75,34.38,34.38,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19223350,,Injection for shoulder x-ray,A,,0.98,3.63,,0.19,,0.09,4.70,1.26,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19323395,,Muscle transfer shoulder/arm,A,,18.08,13.46,NA,13.46,,3.72,35.26,35.26,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19423397,,Muscle transfers,A,,16.34,11.40,NA,11.40,,3.48,31.22,31.22,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,19523400,,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