Billing code 23935: Bone drainageMedicare rate & RVUs in Missouri
Reports deep operative drainage involving the humerus or elbow when the surgeon opens the bone cortex to reach and drain the affected site.
CMS doesn’t publish an office rate for 23935 in Missouri.
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 23935 covers
This service involves a deep incision to reach the humerus or elbow and opening the bone cortex to drain an affected site, such as a bone abscess. It is typically performed by an orthopedic surgeon in an operating room when the infection or collection requires access through the cortex rather than drainage of a superficial or soft-tissue space.
Select 23935 when the operative work includes opening the cortex of the humerus or elbow; the operative report should identify the anatomic site, the deep collection or bone involvement, and the cortical opening and drainage performed. CMS classifies the service as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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.
Where 23935 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | Unavailable | $479.44 |
| Metropolitan St. Louis | Unavailable | $483.70 |
| Rest Of Missouri | Unavailable | $460.51 |
How the 23935 rate is calculated
Each of 23935’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 · 23935
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.22Practice expense 7.31Malpractice 1.30
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23935
23935 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23935
Bone drainage
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 23935
Bone drainage
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 50 · payment effect
With and without the modifier
23935 without 50 · national facility
$495.34
Bone drainage
23935-50 · Bilateral: 150%
$743.01
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
23935 compared with similar codes
Compare codes
23935 vs 23930 vs 23931 vs 23035: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23930Deep drainage
- 23930 describes deep drainage in the upper arm or elbow area. Choose 23935 when the operative service includes opening the humerus or elbow cortex.
- 23931Bursal drainage
- 23931 is for drainage of an upper-arm or elbow bursa; 23935 involves a deep site reached by opening bone cortex.
- 23035Bone incision
- Both involve deep drainage with cortical opening, but 23035 is for the shoulder area; 23935 is for the humerus or elbow.
23935 billing questions
When should I choose 23935 instead of 23930?
Use 23935 when the surgeon opens the bone cortex of the humerus or elbow to drain the deep site. Code 23930 describes deep drainage in the upper arm or elbow area without that cortical opening.
How is 23935 different from drainage of an elbow bursa?
23935 involves opening the humerus or elbow cortex. Use 23931 when the operative target is an upper-arm or elbow bursa.
What documentation supports 23935?
The operative report should identify the humerus or elbow site and describe the deep approach, cortical opening, and drainage performed.
What does the 90-day global period include?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can 23935 be reported bilaterally?
For a bilateral procedure, CMS pays the service with modifier 50 at 150%.
When can an assistant surgeon be paid?
Assistant-at-surgery payment is allowed only when medical necessity is documented. CMS does not permit co-surgeons or team surgery 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 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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