No office rate
Both describe sequestrectomy, but 23170 is for the clavicle; 23172 is for the scapula.
On this page
CMS RVU26D · Effective 2026-10-01
23172 Sequestrectomy Medicare reimbursement rates in Missouri
Removal of a separated, devitalized bone fragment from the scapula, typically during surgical treatment of osteomyelitis or another process producing sequestrum. Compare 23172 office and facility rates across CMS payment localities in Missouri.
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 23172 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$508.93–$533.51
3 of 3 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.
Where 23172 pays more and less in Missouri
Orthopedic surgery
About 23172: Scapular bone sequestrectomy
Removal of a separated, devitalized bone fragment from the scapula, typically during surgical treatment of osteomyelitis or another process producing sequestrum.
Code 23172 represents operative removal of a sequestrum, a discrete piece of devitalized bone, from the scapula. An orthopedic surgeon typically performs the procedure when infection, such as chronic osteomyelitis, has left nonviable scapular bone requiring surgical removal. The documented operative site must be the scapula; sequestrectomy of the clavicle or humeral head has a different code. These procedures are generally performed in an operating-room setting.
Report the code when the operative record identifies scapular sequestrum and describes its removal. Documentation should establish the site, the presence of devitalized bone, and the work performed. This is major surgery: the day-before preoperative visit and 90 days of related postoperative care are included. 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%. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 23172
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.13 · 44%
- Practice expense (office) RVU7.71 · 47%
- Malpractice RVU1.50 · 9%
14
Medicare services in 2024 · #6090 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.
23172 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
23174 applies to sequestrectomy of the humeral head or surgical neck, not the scapula.
No office rate
23182 describes partial excision of scapular bone. Choose 23172 when the operative target is a sequestrum.
No office rate
23190 describes partial ostectomy of the scapula; 23172 is specific to removal of a sequestrum.
Compare 23172 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$528.91
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$533.51
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$508.93
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23172 billing questions
How is this code distinguished from clavicular or humeral sequestrectomy?
The site determines the code: 23172 is for sequestrum removed from the scapula. Clavicular and humeral-head/surgical-neck sequestrectomy have separate codes.
When would a scapular bone excision code be considered instead?
Use the procedure that matches the documented work. Code 23172 describes removal of a sequestrum; a partial scapular excision or ostectomy code describes a different bone-removal procedure.
What should the operative report document?
Document the scapular site, the devitalized bone or sequestrum identified, and its operative removal. The record should distinguish this work from removal of bone at another shoulder-girdle site.
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 surgical global period.
How is bilateral reporting handled?
When the procedure is bilateral, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted for this code.
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.
2,17523155,,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
2,17623156,,Removal of humerus lesion,A,,8.88,8.46,NA,8.46,,1.90,19.24,19.24,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17723170,,Sequestrectomy clavicle,A,,7.03,7.68,NA,7.68,,1.48,16.19,16.19,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17823172,,Sequestrectomy scapula,A,,7.13,7.71,NA,7.71,,1.50,16.34,16.34,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17923174,,Sqstrctmy humrl head srg nck,A,,9.80,9.81,NA,9.81,,2.09,21.70,21.70,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18023180,,Prtl excision bone clavicle,A,,8.77,8.98,NA,8.98,,1.86,19.61,19.61,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18123182,,Prtl excision bone scapula,A,,8.39,9.02,NA,9.02,,1.78,19.19,19.19,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00