Billing code 23450: Shoulder stabilizationMedicare rate & RVUs in Ohio
Open anterior shoulder capsular tightening using a Putti-Platt approach is reported for surgical stabilization of recurrent anterior instability when this technique is performed.
CMS doesn’t publish an office rate for 23450 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 23450 covers
This open stabilization procedure tightens the front of the shoulder capsule, classically with tightening or overlap of the subscapularis, to limit recurrent anterior translation. An orthopedic shoulder surgeon typically performs it in an operating room for a patient with recurrent anterior shoulder instability when the Putti-Platt technique is used.
Select the code from the operative technique, not simply the diagnosis of shoulder instability. The operative report should identify the anterior capsular repair, the technique performed, the side, and any separately described labral work. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. For multiple procedures in the same 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%. An assistant at surgery may be paid; 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.
23450 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $843.79 |
How the 23450 rate is calculated
Each of 23450’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 · 23450
RVUs × geographic indexes × conversion factor
Work13.36
13.36 RVUs× 1.000 GPCI
Practice expense9.89
9.89 RVUs× 1.000 GPCI
Malpractice2.85
2.85 RVUs× 1.000 GPCI
Adjusted RVUs
26.1000
Conversion factor
$33.4009
Medicare rate
$871.76
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23450
23450 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23450
Shoulder stabilization
| 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 · 23450
Shoulder stabilization
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
23450 without 50 · national facility
$871.76
Shoulder stabilization
23450-50 · Bilateral: 150%
$1,307.64
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).
23450 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 23455Shoulder stabilization
- 23450 is the Putti-Platt anterior capsular repair. 23455 applies when the anterior repair also includes labral repair.
- 23460Shoulder stabilization
- 23460 describes anterior stabilization with a bone-block technique; 23450 is the Putti-Platt capsular tightening approach.
- 23465Shoulder capsule repair
- 23465 is for posterior capsular stabilization, rather than the anterior stabilization represented by 23450.
- 23466Shoulder stabilization
- 23466 addresses multidirectional capsular instability; 23450 describes the anterior Putti-Platt approach.
23450 billing questions
How is 23450 distinguished from 23455?
23450 describes the Putti-Platt anterior capsular stabilization technique. Use 23455 when the anterior capsulorrhaphy includes labral repair.
What operative details support 23450?
The note should document the anterior capsular tightening and identify the Putti-Platt technique, side, and structures addressed. The diagnosis alone does not establish the procedure performed.
Does the 90-day global include postoperative visits?
Related postoperative care during the 90 days after surgery is included, along with the day-before preoperative visit.
How is bilateral 23450 reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral service at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction 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 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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