Billing code 23920: Shoulder amputationMedicare rate & RVUs in Rhode Island
Reports removal of an upper extremity through the shoulder joint, typically when trauma, tumor, or disease makes the limb unsalvageable.
CMS doesn’t publish an office rate for 23920 in Rhode Island.
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 23920 covers
This operation removes the arm at the shoulder joint. It may be performed for a severely damaged, nonviable limb or to treat a tumor or other disease that cannot be managed with a more distal amputation. Orthopedic, trauma, or musculoskeletal oncology surgeons typically perform it in an operating room. The level is the shoulder joint, rather than a forequarter amputation that also removes the scapula and part of the clavicle.
Report 23920 when the operative record supports disarticulation at the shoulder joint; document the indication, amputation level, and extent of removal. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; 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.
23920 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | Unavailable | $1,045.34 |
How the 23920 rate is calculated
Each of 23920’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 · 23920
RVUs × geographic indexes × conversion factor
Work15.82
15.82 RVUs× 1.000 GPCI
Practice expense11.79
11.79 RVUs× 1.000 GPCI
Malpractice3.36
3.36 RVUs× 1.000 GPCI
Adjusted RVUs
30.9700
Conversion factor
$33.4009
Medicare rate
$1,034.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23920
23920 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23920
Shoulder amputation
| 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 · 23920
Shoulder amputation
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
23920 without 50 · national facility
$1,034.43
Shoulder amputation
23920-50 · Bilateral: 150%
$1,551.65
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).
23920 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23900Shoulder amputation
- 23920 removes the arm through the shoulder joint. 23900 describes the more extensive forequarter amputation involving shoulder-girdle structures.
- 23921Amputation closure
- 23920 reports the shoulder disarticulation; 23921 applies to secondary closure after that amputation.
- 23929Unlisted procedure shoulder
- Use 23920 when the operation is a shoulder-joint disarticulation. 23929 is for a shoulder procedure without a more specific code.
23920 billing questions
How is 23920 distinguished from a forequarter amputation?
23920 describes removal through the shoulder joint. A forequarter amputation removes additional shoulder-girdle structures and is represented by 23900.
When is 23921 used instead?
23921 is for secondary closure after shoulder disarticulation, not the initial amputation. Use 23920 for the disarticulation itself.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is a bilateral procedure reported?
CMS identifies this as a bilateral procedure; when reported with modifier 50, it is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, while 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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