No office rate
This code is for removal of a sequestrum from a specified humeral site. Code 23184 describes partial excision of proximal humeral bone, so the operative extent determines the choice.
On this page
CMS RVU26D · Effective 2026-10-01
23174 Sequestrectomy Medicare reimbursement rates in Pennsylvania
Reports operative removal of a sequestrum from the humeral head or surgical neck, typically to address devitalized bone associated with osteomyelitis. Compare 23174 office and facility rates across CMS payment localities in Pennsylvania.
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 23174 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$694.09–$757.60
2 of 2 localities have a supported rate.
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 23174: Humeral head or neck sequestrectomy
Reports operative removal of a sequestrum from the humeral head or surgical neck, typically to address devitalized bone associated with osteomyelitis.
An orthopedic surgeon uses this procedure to remove a sequestrum, a fragment of dead bone, from the humeral head or surgical neck. It is typically performed in an operating room when diseased bone requires operative treatment, such as in a case of chronic bone infection. The operative report should identify the humeral site and describe removal of the sequestrum rather than a broader bone resection or excision of a bone lesion.
Report the code when the documented procedure matches that site and scope; the operative note should support the diagnosis, location, and bone removed. Medicare treats it 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 are performed 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%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 23174
- 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 RVU9.80 · 45%
- Practice expense (office) RVU9.81 · 45%
- Malpractice RVU2.09 · 10%
32
Medicare services in 2024 · #5612 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.
23174 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
23195
No office rateHumeral head resection
Code 23195 describes resection of the humeral head. Choose this code when the documented work is sequestrectomy at the humeral head or surgical neck, not a broader head resection.
No office rate
Both codes describe sequestrectomy, but 23172 is for the scapula; this code is for the humeral head or surgical neck.
No office rate
Code 23150 is a humeral bone-lesion removal code. This code is specific to removing a sequestrum from the humeral head or surgical neck.
Compare 23174 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$757.60
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$694.09
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23174 billing questions
When should this code be chosen instead of a proximal humerus partial excision code?
Use this code when the operative work is removal of a sequestrum from the humeral head or surgical neck. A broader removal of proximal humeral bone may point to a different procedure code.
How does this differ from a humeral head resection?
This code describes removal of devitalized bone at the humeral head or surgical neck. A humeral head resection represents a broader resection rather than removal of a sequestrum.
What documentation supports reporting this procedure?
The operative report should identify the humeral head or surgical neck and describe removal of the sequestrum. Documentation should distinguish that work from removal of a bone lesion or a larger bone segment.
What is included in the Medicare global period?
The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are bilateral procedures and other same-session procedures paid?
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 others at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with 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.
2,17623156,,Removal of humerus lesion,A,,8.88,8.46,NA,8.46,,1.90,19.24,19.24,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17723170,,Sequestrectomy clavicle,A,,7.03,7.68,NA,7.68,,1.48,16.19,16.19,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17823172,,Sequestrectomy scapula,A,,7.13,7.71,NA,7.71,,1.50,16.34,16.34,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17923174,,Sqstrctmy humrl head srg nck,A,,9.80,9.81,NA,9.81,,2.09,21.70,21.70,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18023180,,Prtl excision bone clavicle,A,,8.77,8.98,NA,8.98,,1.86,19.61,19.61,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18123182,,Prtl excision bone scapula,A,,8.39,9.02,NA,9.02,,1.78,19.19,19.19,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18223184,,Prtl excision bone prox hum,A,,9.65,9.16,NA,9.16,,2.04,20.85,20.85,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00