CPT 23802: Shoulder fusionMedicare rate & RVUs in Ohio
Reports surgical fusion of the shoulder’s glenohumeral joint using bone graft, typically as a salvage procedure for a painful or unstable shoulder.
CMS doesn’t publish an office rate for 23802 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 23802 covers
An orthopedic surgeon fuses the humeral head to the glenoid with fixation and bone graft to create a stable shoulder. This is a salvage operation for situations such as a painful, unstable shoulder after failed reconstruction or when joint replacement is unsuitable. The procedure is performed in an operating room, with graft placement supporting bony union across the joint.
Report this code when the operative record supports glenohumeral arthrodesis with bone graft; use the no-graft sibling code when the fusion is performed without graft. Document the joint fused, graft use, fixation, and clinical reason for fusion. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are reduced to 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.
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.
23802 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,143.87 |
How the 23802 rate is calculated
Each of 23802’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 · 23802
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.96Practice expense 13.61Malpractice 3.83
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23802
23802 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23802
Shoulder fusion
| 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 · 23802
Shoulder fusion
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
23802 without 50 · national facility
$1,182.39
Shoulder fusion
23802-50 · Bilateral: 150%
$1,773.59
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).
23802 compared with similar codes
Compare codes
23802 vs 23800 vs 23472 vs 23470: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23800Shoulder fusion
- Both codes describe glenohumeral arthrodesis; select 23802 when bone graft is used and 23800 when it is not.
- 23472Shoulder arthroplasty
- 23472 describes total shoulder joint replacement. This code describes fusion of the glenohumeral joint with bone graft.
- 23470Shoulder arthroplasty
- 23470 describes shoulder hemiarthroplasty, while this code is for fusing the glenohumeral joint with bone graft.
23802 billing questions
When should I report this instead of 23800?
Report 23802 when the glenohumeral fusion includes bone graft. Use 23800 for the fusion without graft.
Can the bone graft harvest be billed separately?
The graft is part of this grafted arthrodesis service. Do not separately report a graft-harvest service for work included in the procedure.
What documentation supports this code?
The operative report should identify the glenohumeral joint fusion, bone graft use, fixation, and the clinical reason for the salvage procedure.
How are bilateral procedures handled?
CMS pays bilateral reporting with modifier 50 at 150%. Document the procedure on both shoulders.
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.
What postoperative care is included?
The 90-day global 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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