Billing code 23430: Biceps surgeryMedicare rate & RVUs in Ohio
Reports open surgical fixation of the long head of the biceps tendon, commonly performed for a painful or damaged tendon during shoulder surgery.
CMS doesn’t publish an office rate for 23430 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 23430 covers
An orthopedic surgeon releases the long head of the biceps tendon from its shoulder attachment and secures it to the humerus through an open approach. The operation is commonly performed in an operating room for a diseased, unstable, or ruptured tendon causing shoulder symptoms. It may be performed as a standalone procedure or during a shoulder operation such as repair of a rotator cuff tear.
Report this code for the open tendon-fixation procedure, not for arthroscopic-only fixation or simple tendon release. The operative report should identify the long-head tendon, describe the open fixation and its site, and clarify any other procedures performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires 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.
23430 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $670.96 |
How the 23430 rate is calculated
Each of 23430’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 · 23430
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.92Practice expense 8.94Malpractice 1.99
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23430
23430 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23430
Biceps surgery
| 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 · 23430
Biceps surgery
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
23430 without 50 · national facility
$696.41
Biceps surgery
23430-50 · Bilateral: 150%
$1,044.62
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).
23430 compared with similar codes
Compare codes
23430 vs 29828 vs 23440 vs 23412: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 29828Biceps tenodesis
- Use 23430 for open fixation of the long-head biceps tendon; 29828 describes arthroscopic tenodesis.
- 23440Biceps tenodesis
- 23430 fixes the tendon to another site. 23440 is used when the long-head tendon is released without fixation.
- 23412Rotator cuff repair
- 23412 addresses repair of a chronic rotator cuff tear, not fixation of the long-head biceps tendon. Both procedures may be performed in one operation.
23430 billing questions
How does this code differ from arthroscopic biceps tenodesis?
This code describes open fixation of the long-head biceps tendon. For fixation performed arthroscopically, consider 29828 instead.
When is tendon release reported instead of fixation?
A release without securing the tendon elsewhere is a tenotomy, not a tenodesis. The long-head biceps tenotomy code is 23440.
Can this be reported with a rotator cuff repair?
It may be performed during the same shoulder operation as a rotator cuff repair. Document the separate tendon condition and the work performed; multiple-procedure payment reduction may apply.
What documentation supports this code?
Document the affected long-head tendon, the reason for surgery, the open approach, and how and where the tendon was secured. Include the distinct work when another shoulder procedure is performed.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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