Billing code 23670: Shoulder surgeryMedicare rate & RVUs in Oregon
Reports open treatment of a shoulder dislocation accompanied by a greater tuberosity fracture, including internal fixation when performed.
CMS doesn’t publish an office rate for 23670 in Oregon.
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 23670 covers
An orthopedic surgeon uses an open approach to treat a shoulder joint dislocation associated with a fracture of the humeral greater tuberosity. The operation addresses the dislocation and the associated fracture; internal fixation is included when performed. This service is generally performed in an operating room for a traumatic injury requiring open treatment, rather than closed reduction alone.
Choose this code when the operative record supports both the shoulder dislocation and the greater tuberosity fracture, and documents open treatment. Record the fracture location, the work performed to treat the dislocation and fracture, and any fixation used. CMS classifies the procedure as major surgery with 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 is paid in full and others at 50%. For bilateral procedures reported with modifier 50, payment is 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.
Where 23670 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $839.54 |
| Rest Of Oregon | Unavailable | $791.32 |
How the 23670 rate is calculated
Each of 23670’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 · 23670
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.97Practice expense 9.99Malpractice 2.52
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23670
23670 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23670
Shoulder surgery
| 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 · 23670
Shoulder surgery
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
23670 without 50 · national facility
$817.65
Shoulder surgery
23670-50 · Bilateral: 150%
$1,226.48
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).
23670 compared with similar codes
Compare codes
23670 vs 23665 vs 23660 vs 23680: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23665Shoulder reduction
- Both concern a shoulder dislocation with a greater tuberosity fracture. Choose 23670 for open treatment and 23665 for closed treatment.
- 23660Shoulder dislocation
- Code 23660 is open treatment of an acute shoulder dislocation without the greater tuberosity fracture combination covered by 23670.
- 23680Shoulder fracture-dislocation
- Both describe open treatment of a shoulder dislocation with an associated fracture; 23680 is for a surgical neck fracture rather than a greater tuberosity fracture.
23670 billing questions
When should this code be chosen over 23665?
Use 23670 for open treatment of the shoulder dislocation with an associated greater tuberosity fracture. Code 23665 describes closed treatment of that injury pattern.
Is internal fixation separately reported?
Internal fixation, when performed as part of this open treatment, is included in the service. Document the fixation in the operative report.
How does this differ from 23660?
Code 23670 includes an associated greater tuberosity fracture. Code 23660 is for open treatment of an acute shoulder dislocation without that fracture combination.
What documentation supports reporting 23670?
The operative report should identify the shoulder dislocation and greater tuberosity fracture, describe the open treatment of both, and record any fixation performed.
How does the 90-day global affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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 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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