No office rate
Use 23450 for anterior capsular repair without labral repair. This code includes repair of the anterior labrum as well as capsular tightening.
On this page
CMS RVU26D · Effective 2026-10-01
23455 Shoulder stabilization Medicare reimbursement rates in Ohio
Open anterior shoulder stabilization that repairs the detached labrum and tightens the capsule, commonly performed for recurrent instability or dislocation. Compare 23455 office and facility rates across CMS payment localities in Ohio.
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 23455 in Ohio?
Ohio has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$854.07
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
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.
Orthopedic surgery
About 23455: Open anterior labral and capsular repair
Open anterior shoulder stabilization that repairs the detached labrum and tightens the capsule, commonly performed for recurrent instability or dislocation.
This open operation stabilizes the front of the shoulder by reattaching the labrum to the glenoid and tightening the capsule. Orthopedic surgeons commonly perform it for recurrent anterior shoulder instability, including instability after dislocation when the labrum and capsule are detached or lax. The repair is performed in an operating room, typically in a facility setting.
Report this code when the operative work includes both anterior capsular tightening and labral repair; a capsule-only repair is a different service. The operative report should document the instability, labral injury, approach, and repairs performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 23455
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.30 · 54%
- Practice expense (office) RVU9.33 · 35%
- Malpractice RVU2.73 · 10%
123
Medicare services in 2024 · #4711 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.
23455 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
23460 involves a bone-block stabilization technique. This code describes anterior labral repair with capsular tightening, without that bone-block distinction.
No office rate
23462 involves coracoid process transfer for stabilization. This code is the open anterior labral and capsular repair without that transfer.
No office rate
29806 describes arthroscopic capsulorrhaphy. This code is used for the open anterior repair that includes labral reattachment.
Compare 23455 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.
1 of 1 payment localities
Ohio →
Office / nonfacility
Unavailable
Facility
$854.07
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 23455 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
2,205
- Code
- 23455
- Physician work
- 14.30
- Practice expense
- 9.33
- Malpractice
- 2.73
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.30 | × 1.000 | 14.3000 |
| Practice expense | 9.33 | × 0.913 | 8.5183 |
| Malpractice | 2.73 | × 1.008 | 2.7518 |
| Total RVUs | 25.5701 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$854.07
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.3 | 1 |
| Practice expense | 9.33 | 0.913 |
| Malpractice | 2.73 | 1.008 |
(14.3 × 1 + 9.33 × 0.913 + 2.73 × 1.008) × $33.4009 = $854.07
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
23455 billing questions
How does this differ from 23450?
This code includes repair of the anterior labrum along with capsular tightening. Code 23450 describes anterior capsular repair without the labral repair.
Can the labral repair be billed separately?
The labral repair is part of this service. Do not report a separate code for that same repair.
When is 29806 considered instead?
Code 29806 describes arthroscopic shoulder capsulorrhaphy. This code represents the open anterior repair, so the documented surgical approach helps distinguish them.
What should the operative report support?
Document the anterior instability, the labral detachment or injury, and the open capsular and labral work performed. The record should make clear that both structures were repaired.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are bilateral procedures and assistants handled?
When performed bilaterally and reported with modifier 50, CMS pays at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation.
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.
2,20223430,,Repair biceps tendon,A,,9.92,8.94,NA,8.94,,1.99,20.85,20.85,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20323440,,Remove/transplant tendon,A,,10.37,8.46,NA,8.46,,2.17,21.00,21.00,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20423450,,Repair shoulder capsule,A,,13.36,9.89,NA,9.89,,2.85,26.10,26.10,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20523455,,Repair shoulder capsule,A,,14.30,9.33,NA,9.33,,2.73,26.36,26.36,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20623460,,Repair shoulder capsule,A,,15.42,11.26,NA,11.26,,3.28,29.96,29.96,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20723462,,Repair shoulder capsule,A,,15.33,10.67,NA,10.67,,3.26,29.26,29.26,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,20823465,,Repair shoulder capsule,A,,15.89,11.41,NA,11.41,,3.38,30.68,30.68,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703