No office rate
Use 23073 for a deep shoulder tumor measuring 5 cm or larger; this code is for a deep tumor under 5 cm.
On this page
CMS RVU26D · Effective 2026-10-01
23076 Shoulder tumor excision Medicare reimbursement rates in Tennessee
Open excision of a deep soft-tissue tumor in the shoulder area measuring under 5 cm, such as an intramuscular mass, is reported with this code. Compare 23076 office and facility rates across CMS payment localities in Tennessee.
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 23076 in Tennessee?
Tennessee 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
$477.46
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 23076: Deep shoulder soft-tissue tumor excision
Open excision of a deep soft-tissue tumor in the shoulder area measuring under 5 cm, such as an intramuscular mass, is reported with this code.
This service involves surgically removing a soft-tissue tumor beneath the superficial fascia in the shoulder area, including a mass located within muscle. An orthopedic surgeon or another surgeon may perform it in a hospital or outpatient surgical setting. A deep lipomatous mass is one typical clinical example; the code is based on the tumor’s depth and size, not simply the length of the incision.
Select this code when the tumor is deep and measures less than 5 cm; document its location, depth, and size, along with the excision performed. The 90-day global period includes 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 the others at 50%. For bilateral procedures reported with modifier 50, payment is 150%. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.
CMS billing rules for 23076
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.22 · 46%
- Practice expense (office) RVU6.82 · 44%
- Malpractice RVU1.63 · 10%
719
Medicare services in 2024 · #3235 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.
23076 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
23071 describes excision of a superficial shoulder lesion measuring 3 cm or larger. Choose this code for a deep tumor under 5 cm.
$505.33
23075 is for a superficial shoulder lesion under 3 cm. Depth distinguishes it from this code, which covers a deep tumor under 5 cm.
No office rate
23077 describes radical resection of a shoulder tumor under 5 cm. This code describes deep tumor excision without that radical-resection distinction.
Compare 23076 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$477.46
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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 23076 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
2,160
- Code
- 23076
- Physician work
- 7.22
- Practice expense
- 6.82
- Malpractice
- 1.63
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.22 | × 1.000 | 7.2200 |
| Practice expense | 6.82 | × 0.909 | 6.1994 |
| Malpractice | 1.63 | × 0.537 | 0.8753 |
| Total RVUs | 14.2947 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$477.46
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.22 | 1 |
| Practice expense | 6.82 | 0.909 |
| Malpractice | 1.63 | 0.537 |
(7.22 × 1 + 6.82 × 0.909 + 1.63 × 0.537) × $33.4009 = $477.46
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.
23076 billing questions
How does this differ from 23073?
Both describe deep shoulder tumor excision. Use 23076 for a tumor under 5 cm and 23073 for one measuring 5 cm or larger.
How does this differ from 23071 or 23075?
Those codes describe superficial shoulder lesion excision. This code is for a tumor beneath the superficial fascia, including an intramuscular tumor.
When would 23077 be considered instead?
23077 describes radical resection of a shoulder tumor under 5 cm. The distinction is the radical resection described by that code, not tumor size alone.
What documentation supports selecting this code?
Document the shoulder-area location, the tumor’s depth relative to the superficial fascia, its size, and the excision performed. The incision length alone does not establish the tumor size.
How are bilateral cases and other same-session procedures handled?
Modifier 50 identifies a bilateral procedure and CMS payment is 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported for this operation?
CMS does not pay for an assistant at surgery for this code. Co-surgeons and team surgery 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.
2,15723071,,Exc shoulder les sc 3 cm/>,A,,5.76,5.06,NA,5.06,,1.37,12.19,12.19,0,090,0.10,0.80,0.10,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15823073,,Exc shoulder tum deep 5 cm/>,A,,9.88,7.57,NA,7.57,,2.27,19.72,19.72,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15923075,,Exc shoulder les sc < 3 cm,A,,4.10,11.59,,4.60,,0.92,16.61,9.62,0,090,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16023076,,Exc shoulder tum deep < 5 cm,A,,7.22,6.82,NA,6.82,,1.63,15.67,15.67,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16123077,,Rad rescj tum shoulder<5 cm,A,,17.22,10.33,NA,10.33,,3.93,31.48,31.48,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16223078,,Rad rescj tum shoulder 5cm/>,A,,21.99,12.68,NA,12.68,,5.02,39.69,39.69,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16323100,,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
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780