No office rate
This code is for sternoclavicular synovectomy. Code 23101 is the biopsy-focused arthrotomy option for the sternoclavicular or acromioclavicular joint.
On this page
CMS RVU26D · Effective 2026-10-01
23106 Joint surgery Medicare reimbursement rates in Rhode Island
Reports open removal of diseased synovial tissue from the sternoclavicular joint, such as for persistent synovitis requiring operative treatment. Compare 23106 office and facility rates across CMS payment localities in Rhode Island.
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 23106 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$495.27
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
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 23106: Open sternoclavicular synovectomy
Reports open removal of diseased synovial tissue from the sternoclavicular joint, such as for persistent synovitis requiring operative treatment.
The surgeon opens the sternoclavicular joint and removes abnormal synovial tissue. Orthopedic surgeons typically perform this operation in a hospital or ambulatory surgical setting for conditions such as persistent inflammatory synovitis affecting the joint. The operative report should identify the sternoclavicular joint, describe the synovial disease and removal performed, and support why an open synovectomy was needed.
Report this code when the operative service is synovial-tissue removal at the sternoclavicular joint, rather than a biopsy-focused arthrotomy or a procedure directed at clavicular bone. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 23106
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.98 · 41%
- Practice expense (office) RVU7.35 · 50%
- Malpractice RVU1.28 · 9%
11
Medicare services in 2024 · #6160 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.
23106 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
Both involve open synovectomy, but 23105 applies to the glenohumeral joint; 23106 applies to the sternoclavicular joint.
No office rate
Code 23120 removes part of the clavicle. Use 23106 for synovial-tissue removal at the sternoclavicular joint, not bone excision.
Compare 23106 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.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
Unavailable
Facility
$495.27
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 23106 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,166
- Code
- 23106
- Physician work
- 5.98
- Practice expense
- 7.35
- Malpractice
- 1.28
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.98 | × 1.019 | 6.0936 |
| Practice expense | 7.35 | × 1.033 | 7.5925 |
| Malpractice | 1.28 | × 0.892 | 1.1418 |
| Total RVUs | 14.8279 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$495.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.98 | 1.019 |
| Practice expense | 7.35 | 1.033 |
| Malpractice | 1.28 | 0.892 |
(5.98 × 1.019 + 7.35 × 1.033 + 1.28 × 0.892) × $33.4009 = $495.27
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
23106 billing questions
How does this differ from code 23101?
Use 23106 when the surgeon performs an open synovectomy of the sternoclavicular joint. Code 23101 describes an arthrotomy of the acromioclavicular or sternoclavicular joint that includes biopsy; the operative objective and work performed distinguish the services.
Can modifier 50 be reported when both sternoclavicular joints are treated?
Yes. The CMS rule for this code pays bilateral reporting with modifier 50 at 150%. The operative documentation should support treatment of both joints.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is this paid with another procedure performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.
Is an assistant surgeon or co-surgeon payable?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are paid only when supporting documentation is provided.
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.
2,16323100,,Arthrotomy glenhumrl jt w/bx,A,,6.05,7.37,NA,7.37,,1.29,14.71,14.71,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16423101,,Arthrt acrmclv/strnclav jt,A,,5.58,6.50,NA,6.50,,1.20,13.28,13.28,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16523105,,Arthrotomy glenohumeral jt,A,,8.27,8.13,NA,8.13,,1.72,18.12,18.12,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16623106,,Arthrotomy strnclav joint,A,,5.98,7.35,NA,7.35,,1.28,14.61,14.61,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16723107,,Arthrt glenhumrl jt w/expl,A,,8.65,8.30,NA,8.30,,1.80,18.75,18.75,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16823120,,Claviculectomy partial,A,,7.21,8.22,NA,8.22,,1.48,16.91,16.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16923125,,Claviculectomy total,A,,9.40,8.63,NA,8.63,,2.00,20.03,20.03,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537