Billing code 23040: Shoulder arthrotomyMedicare rate & RVUs in Oklahoma
An open operation on the glenohumeral joint for exploration, drainage, or removal of an intra-articular foreign body, typically performed by an orthopedic surgeon.
CMS doesn’t publish an office rate for 23040 in Oklahoma.
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 23040 covers
This code describes open entry into the glenohumeral joint to inspect the joint, drain it, or remove a foreign body. An orthopedic surgeon may perform it in a hospital or other surgical facility when the treatment requires open access to the shoulder joint, such as for an intra-articular problem that cannot be managed with needle aspiration or a less invasive approach. It is distinct from procedures directed at the acromioclavicular joint, shoulder bursa, or surrounding soft tissues.
Select the code when the operative report supports open joint entry and identifies the purpose, such as exploration, drainage, or foreign-body removal. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral treatment, 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.
23040 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $627.41 |
How the 23040 rate is calculated
Each of 23040’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 · 23040
RVUs × geographic indexes × conversion factor
Work9.51
9.51 RVUs× 1.000 GPCI
Practice expense8.68
8.68 RVUs× 1.000 GPCI
Malpractice1.96
1.96 RVUs× 1.000 GPCI
Adjusted RVUs
20.1500
Conversion factor
$33.4009
Medicare rate
$673.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23040
23040 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23040
Shoulder arthrotomy
| 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 · 23040
Shoulder arthrotomy
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
23040 without 50 · national facility
$673.03
Shoulder arthrotomy
23040-50 · Bilateral: 150%
$1,009.55
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).
23040 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 23044Joint arthrotomy
- Choose 23040 for open work on the glenohumeral joint; 23044 concerns the acromioclavicular joint.
- 23030Shoulder drainage
- 23030 is for deep shoulder abscess or hematoma drainage. Use 23040 when the operative target is the glenohumeral joint.
- 23031Bursa drainage
- 23031 addresses drainage of an infected shoulder bursa, not open exploration or drainage of the glenohumeral joint.
- 29805Shoulder arthroscopy
- 29805 describes diagnostic shoulder arthroscopy. This code is for open entry into the glenohumeral joint for exploration, drainage, or foreign-body removal.
23040 billing questions
How is this code distinguished from 23044?
This code concerns open exploration, drainage, or foreign-body removal in the glenohumeral joint. Code 23044 addresses the acromioclavicular joint.
Can it be reported for drainage of a shoulder abscess?
Use it when the operation enters and treats the glenohumeral joint. Code 23030 is for deep shoulder abscess or hematoma drainage outside that joint.
Does the code describe arthroscopic treatment?
No. It describes an open joint procedure. Diagnostic shoulder arthroscopy is represented by a different code, such as 29805.
What should the operative report document?
Document open entry into the glenohumeral joint and the specific purpose—exploration, drainage, or removal of a foreign body. Identify the treated joint so the service can be distinguished from work on the AC joint, bursa, or surrounding tissues.
How are bilateral procedures and other same-session procedures handled?
Modifier 50 is paid at 150% for bilateral treatment. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.
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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