Billing code 23075: Shoulder excisionMedicare rate & RVUs in Oregon
Reports surgical removal of a subcutaneous soft-tissue lesion in the shoulder area when the lesion measures less than 3 cm.
Medicare pays $544.11–$592.08 for 23075 in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.
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 23075 covers
A surgeon removes a soft-tissue lesion from the subcutaneous layer of the shoulder area, such as a small lipoma, rather than sampling it for diagnosis alone. The procedure may be performed in an office-based operating room or a hospital or ambulatory surgery facility. The key distinctions are the lesion’s size and its depth: it is under 3 cm and remains superficial to the deep fascia.
The operative report should identify the shoulder site, lesion size, tissue plane, and whether the lesion was excised. This major surgery code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same 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 services are not paid; co-surgeons and team surgery are 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.
Where 23075 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $592.08 | $332.70 |
| Rest Of Oregon | $544.11 | $311.58 |
How the 23075 rate is calculated
Each of 23075’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 · 23075
RVUs × geographic indexes × conversion factor
Work4.10
4.10 RVUs× 1.000 GPCI
Practice expense11.59
11.59 RVUs× 1.000 GPCI
Malpractice0.92
0.92 RVUs× 1.000 GPCI
Adjusted RVUs
16.6100
Conversion factor
$33.4009
Medicare rate
$554.79
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23075
23075 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23075
Shoulder excision
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 23075
Shoulder excision
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
23075 without 50 · national office
$554.79
Shoulder excision
23075-50 · Bilateral: 150%
$832.19
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).
23075 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23071Shoulder mass excision
- Both describe subcutaneous shoulder lesion excision; choose 23071 when the lesion is 3 cm or larger, rather than under 3 cm.
- 23076Shoulder tumor excision
- Use 23076 for a deep shoulder soft-tissue tumor under 5 cm. This code is for a subcutaneous lesion under 3 cm.
- 23065Shoulder biopsy
- Use 23065 when shoulder tissue is biopsied for diagnosis rather than excised as a lesion.
23075 billing questions
When should this be reported instead of 23071?
Use this code for a subcutaneous shoulder lesion under 3 cm. Code 23071 describes the corresponding subcutaneous size category of 3 cm or greater.
How does this differ from 23076?
This code is for a lesion in the subcutaneous layer under 3 cm. Code 23076 describes excision of a deep shoulder soft-tissue tumor under 5 cm.
Can this code be used for a biopsy?
It describes excision, not a diagnostic sample alone. For a shoulder-tissue biopsy, consider the biopsy code that matches the documented tissue depth, such as 23065 for superficial tissue.
What documentation supports the size and depth?
The operative report should state the lesion’s measured size and whether it was confined to subcutaneous tissue or extended below the fascia. Include the shoulder location and the removal performed.
How are bilateral procedures and additional same-session procedures handled?
A bilateral procedure reported 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%.
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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