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CMS RVU26D · Effective 2026-10-01

23406 Tendon release Medicare reimbursement rates in Missouri

Reports operative release of multiple tendons in the shoulder region, such as for a contracture when several tendon structures require division. Compare 23406 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 23406 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

$636.01–$661.35

3 of 3 localities have a supported rate.

Lowest: Rest Of Missouri

Highest: Metropolitan St. Louis

A spread of $25.34 per service.

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.

Find 23406 in your payment locality →

Where 23406 pays more and less in Missouri

Orthopedic surgery

About 23406: Multiple shoulder tendon release

Reports operative release of multiple tendons in the shoulder region, such as for a contracture when several tendon structures require division.

Code 23406 describes an operation that divides or releases multiple tendons in the shoulder region. An orthopedic surgeon may perform it when a shoulder contracture or deformity requires release of several tendon structures. It is distinct from an operation that repairs a torn rotator cuff or secures a tendon to bone.

Select the code based on the operative report’s account of the shoulder-area tendons released; a release of one tendon points to the single-tendon sibling code. Documentation should identify the treated structures and the operative work performed. CMS 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% reduction. The bilateral adjustment does not apply, and modifier 50 is inappropriate. CMS permits assistant-at-surgery payment; co-surgeons and team surgery are not permitted.

CMS billing rules for 23406

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 not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU10.73 · 53%
  • Practice expense (office) RVU7.97 · 39%
  • Malpractice RVU1.48 · 7%

388

Medicare services in 2024 · #3762 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.

23406 compared with similar codes

Office rates for Missouri, from the same CMS release.

23405

Shoulder tenotomy

Single tendon

No office rate

Choose 23405 when one shoulder-area tendon is released; 23406 describes release of multiple tendons.

23410

Rotator cuff repair

Acute tear, open

No office rate

23410 represents repair of an acute rotator cuff tear, while 23406 represents release rather than repair.

23412

Rotator cuff repair

Chronic tear, open repair

No office rate

23412 represents repair of a chronic rotator cuff tear; 23406 is for release of multiple shoulder-area tendons.

23440

Biceps tenodesis

With tendon transfer

No office rate

23440 is directed at the long-head biceps tendon; 23406 describes release of multiple tendons in the shoulder region.

Compare 23406 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

Office and facility base rates · shared scale starting at $0

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23406 billing questions

How does 23406 differ from 23405?

23406 is for release of multiple shoulder-area tendons. Use 23405 when the operative work releases a single tendon.

Does 23406 describe rotator cuff repair?

No. It describes tendon release or division, not repair of a torn rotator cuff. The operative report should support the work actually performed.

Should modifier 50 be appended for both shoulders?

No. CMS identifies the bilateral adjustment as inapplicable to this code and modifier 50 as inappropriate.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon be reported?

CMS permits assistant-at-surgery payment for 23406. Co-surgeons and team surgery are not permitted.

How are other procedures in the same session paid?

CMS applies 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.

RVUs for 23406PPRRVU2026_Oct_nonQPP.csv, line 2,197 (RVU26D)