Billing code 23155: Bone lesion excisionMedicare rate & RVUs in Ohio
Report this operation when a surgeon removes or curettes a benign bone lesion in the humerus and fills the resulting defect with the patient’s own bone.
CMS doesn’t publish an office rate for 23155 in Ohio.
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 23155 covers
An orthopedic surgeon exposes the humerus, removes or curettes a bone cyst or benign tumor, and uses the patient’s own bone graft to fill the defect. The service is generally performed in an operating room, including a hospital outpatient department or ambulatory surgery center. The autograft is the distinguishing feature; a similar humeral lesion procedure without graft or with donor bone is coded differently.
Select this code when the operative report supports the humeral site, lesion removal or curettage, and use of autograft. The code has 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. Modifier 50 applies to bilateral procedures, paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation. 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.
23155 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $721.31 |
How the 23155 rate is calculated
Each of 23155’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 · 23155
RVUs × geographic indexes × conversion factor
Work10.59
10.59 RVUs× 1.000 GPCI
Practice expense9.57
9.57 RVUs× 1.000 GPCI
Malpractice2.25
2.25 RVUs× 1.000 GPCI
Adjusted RVUs
22.4100
Conversion factor
$33.4009
Medicare rate
$748.51
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23155
23155 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23155
Bone lesion excision
| 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) | 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 · 23155
Bone lesion excision
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
23155 without 50 · national facility
$748.51
Bone lesion excision
23155-50 · Bilateral: 150%
$1,122.77
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).
23155 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23150Bone lesion removal
- Choose 23150 for humeral lesion removal or curettage without graft. Choose 23155 when the defect is filled with autograft.
- 23156Bone lesion surgery
- Both address a humeral bone lesion, but 23156 is the allograft option; 23155 identifies use of the patient’s own bone.
- 23184Bone excision
- 23184 describes partial excision of proximal humerus. It is distinct from curettage or excision of a bone cyst or benign tumor with autograft.
23155 billing questions
How is this different from 23150?
23155 describes humeral lesion removal or curettage with autograft. Use 23150 when the procedure is performed without a graft.
When would 23156 be used instead?
23156 is the related humeral lesion procedure when allograft is used. The operative report should identify the graft source.
Is the autograft part of this code?
Yes. Autograft use is the feature that distinguishes this code from the no-graft and allograft options in the humeral lesion group.
What documentation supports reporting 23155?
Document the humeral location, the bone cyst or benign tumor treated, the removal or curettage performed, and use of autograft to fill the defect.
How are bilateral cases and additional procedures handled?
Modifier 50 applies to bilateral procedures, with payment at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
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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