No office rate
Report 23473 when the surgeon revises only the humeral or glenoid component. Report 23474 when both components are revised.
On this page
CMS RVU26D · Effective 2026-10-01
23474 Shoulder revision Medicare reimbursement rates in Ohio
Reports revision of a total shoulder replacement when the surgeon revises both the humeral and glenoid components during the same operation. Compare 23474 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 23474 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
$1511.27
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 23474: Revision of both shoulder replacement components
Reports revision of a total shoulder replacement when the surgeon revises both the humeral and glenoid components during the same operation.
An orthopedic surgeon uses this code when revising both components of a prior total shoulder replacement. The operation may address implant loosening, wear, instability, or another failure requiring revision of the humeral and glenoid sides. It is generally performed in an operating room, most often in a hospital or ambulatory surgery setting. A conversion between shoulder replacement designs may qualify when both components are revised.
Select this code based on the components actually revised, not simply the complexity of the case or the original implant type. The operative report should identify the existing arthroplasty and describe revision of both the humeral and glenoid components; it should also document graft use when applicable. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 23474
- 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 RVU26.53 · 57%
- Practice expense (office) RVU14.56 · 31%
- Malpractice RVU5.38 · 12%
7.3K
Medicare services in 2024 · #1636 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.
23474 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
23472 describes an initial total shoulder replacement. 23474 is for revision of an existing replacement when both components are revised.
No office rate
23470 describes a shoulder hemiarthroplasty, not revision of both components of a total shoulder replacement.
Compare 23474 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
$1511.27
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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 23474 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
2,213
- Code
- 23474
- Physician work
- 26.53
- Practice expense
- 14.56
- Malpractice
- 5.38
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 26.53 | × 1.000 | 26.5300 |
| Practice expense | 14.56 | × 0.913 | 13.2933 |
| Malpractice | 5.38 | × 1.008 | 5.4230 |
| Total RVUs | 45.2463 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$1511.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 26.53 | 1 |
| Practice expense | 14.56 | 0.913 |
| Malpractice | 5.38 | 1.008 |
(26.53 × 1 + 14.56 × 0.913 + 5.38 × 1.008) × $33.4009 = $1511.27
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.
23474 billing questions
When should I report 23474 rather than 23473?
Use 23474 when the surgeon revises both the humeral and glenoid components. Use 23473 when the revision is limited to one of those components.
Does this code describe an initial total shoulder replacement?
No. It describes revision of an existing total shoulder replacement involving both components. An initial total shoulder replacement is reported with 23472.
Is graft use included in the revision service?
The code includes graft use when performed as part of the revision. The operative report should document the graft and the components revised.
What postoperative care is included in the global period?
CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS handle bilateral reporting and multiple procedures?
Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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 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.
2,21023470,,Reconstruct shoulder joint,A,,17.44,11.57,NA,11.57,,3.56,32.57,32.57,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21123472,,Reconstruct shoulder joint,A,,21.58,12.99,NA,12.99,,4.36,38.93,38.93,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21223473,,Revis reconst shoulder joint,A,,24.38,13.85,NA,13.85,,4.89,43.12,43.12,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21323474,,Revis reconst shoulder joint,A,,26.53,14.56,NA,14.56,,5.38,46.47,46.47,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21423480,,Revision of collar bone,A,,11.25,9.22,NA,9.22,,2.40,22.87,22.87,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21523485,,Revision of collar bone,A,,13.56,9.77,NA,9.77,,2.76,26.09,26.09,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21623490,,Reinforce clavicle,A,,11.86,9.58,NA,9.58,,2.53,23.97,23.97,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,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