Billing code 23397: Muscle transferMedicare rate & RVUs in Minnesota
Reports multiple muscle transfers in the shoulder or upper arm, commonly performed to restore movement when paralysis or nerve injury has impaired function.
CMS doesn’t publish an office rate for 23397 in Minnesota.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 23397 covers
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.
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 in Minnesota
| Payment locality | Office | Facility |
|---|---|---|
| Minnesota | Unavailable | $971.99 |
How the 23397 rate is calculated
Each of 23397’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 23397
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 16.34Practice expense 11.40Malpractice 3.48
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23397
23397 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23397
Muscle transfer
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 23397
Muscle transfer
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
23397 without 51 · national facility
$1,042.78
Muscle transfer
23397-51 · Second procedure: 50%
$521.39
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
23397 compared with similar codes
Compare codes
23397 vs 23395 vs 24301 vs 25310: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23395Muscle transfer
- The distinction is the number of transfers: 23395 describes a single shoulder or upper-arm muscle transfer; 23397 is for multiple transfers.
- 24301Tendon transfer
- 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.
- 25310Tendon transfer
- 25310 concerns tendon transfer at the wrist or forearm. 23397 concerns multiple muscle transfers in the shoulder or upper arm.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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