No office rate
Use 23920 when the arm is separated at the shoulder joint and the shoulder girdle is preserved. This code requires removal extending into the scapula and clavicular region.
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CMS RVU26D · Effective 2026-10-01
23900 Shoulder amputation Medicare reimbursement rates in Pennsylvania
Reports removal of the upper limb with the shoulder girdle, typically for extensive malignancy when a more limited amputation cannot remove the disease. Compare 23900 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 23900 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
$1213.02–$1314.72
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.
Upper-extremity surgery
About 23900: Forequarter amputation of the upper limb
Reports removal of the upper limb with the shoulder girdle, typically for extensive malignancy when a more limited amputation cannot remove the disease.
This extensive amputation removes the arm together with the scapula and part of the clavicle. It is most often performed by an orthopedic oncologist for a tumor involving the proximal arm or shoulder girdle when limb-sparing surgery is not feasible. The procedure takes place in an operating room, commonly in a hospital setting.
Choose this code when the operative report supports removal of the shoulder girdle with the limb, rather than separation of the arm at the shoulder joint alone. The report should document the structures removed and the reason for this extent of resection. The 90-day global period includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this procedure. Assistant-at-surgery payment may be made; co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 23900
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU20.20 · 54%
- Practice expense (office) RVU13.13 · 35%
- Malpractice RVU4.30 · 11%
24
Medicare services in 2024 · #5805 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.
23900 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
23921 describes secondary closure or scar revision related to shoulder disarticulation; it is not the initial forequarter amputation.
No office rate
24900 is for amputation through the humerus. Select this code when the shoulder girdle is not removed with the arm.
Compare 23900 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
$1314.72
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1213.02
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23900 billing questions
How is this different from shoulder disarticulation?
This procedure removes the scapula and a portion of the clavicle along with the arm. Shoulder disarticulation separates the arm at the shoulder joint and preserves the shoulder girdle.
What documentation supports reporting this code?
The operative report should identify the arm and shoulder-girdle structures removed, including the scapula and clavicular component, and describe the clinical reason for that extent of resection.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this one-sided forequarter amputation.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures subject to the standard multiple-procedure reduction are paid at 50%. Assistant-at-surgery payment may be made; co-surgeon and team-surgery reporting are 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.
2,24623700,,Mnpj anes sho jt fixj aprats,A,,2.51,2.53,NA,2.53,,0.49,5.53,5.53,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24723800,,Arthrodesis glenohumeral jt,A,,14.36,10.93,NA,10.93,,3.05,28.34,28.34,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24823802,,Arthrd glenohumeral jt w/grf,A,,17.96,13.61,NA,13.61,,3.83,35.40,35.40,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24923900,,Interthoracoscplr amputation,A,,20.20,13.13,NA,13.13,,4.30,37.63,37.63,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25023920,,Disarticulation shoulder,A,,15.82,11.79,NA,11.79,,3.36,30.97,30.97,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25123921,,Disarticulation sho sec clsr,A,,5.58,6.97,NA,6.97,,1.20,13.75,13.75,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,25223929,,Unlisted procedure shoulder,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00