Billing code 23078: Shoulder tumor resectionMedicare rate & RVUs in Texas
Reports radical removal of a shoulder-area soft-tissue tumor measuring at least 5 cm, typically when oncologic resection requires removal beyond a simple local excision.
CMS doesn’t publish an office rate for 23078 in Texas.
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 23078 covers
This code describes radical resection of a soft-tissue tumor in the shoulder area measuring 5 cm or larger. It is commonly used for oncologic operations, such as resection of a suspected or confirmed soft-tissue sarcoma, and is typically performed by an orthopedic oncologic or other qualified surgeon in an operating room. The operative work is more extensive than a routine local excision; the surgeon documents the tumor’s location, size, depth, and the extent of tissue removed.
Select this code when the procedure is a radical resection and the tumor meets the size threshold, rather than a deep-tumor excision or a biopsy. The operative report should support the shoulder-area site, measured size, and radical nature of the removal. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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.
Where 23078 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,332.60 |
| Beaumont | Unavailable | $1,275.66 |
| Brazoria | Unavailable | $1,290.86 |
| Dallas | Unavailable | $1,306.79 |
| Fort Worth | Unavailable | $1,304.73 |
| Galveston | Unavailable | $1,299.75 |
| Houston | Unavailable | $1,391.64 |
| Rest Of Texas | Unavailable | $1,287.82 |
How the 23078 rate is calculated
Each of 23078’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 · 23078
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.99Practice expense 12.68Malpractice 5.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23078
23078 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23078
Shoulder tumor resection
| 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 · 23078
Shoulder tumor resection
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
23078 without 50 · national facility
$1,325.68
Shoulder tumor resection
23078-50 · Bilateral: 150%
$1,988.52
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).
23078 compared with similar codes
Compare codes
23078 vs 23077 vs 23073 vs 23066: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23077Shoulder tumor surgery
- Use 23077 for radical resection of a shoulder-area tumor smaller than 5 cm; 23078 applies at 5 cm or larger.
- 23073Shoulder tumor excision
- Use 23073 for excision of a deep shoulder tumor measuring 5 cm or larger. Use 23078 when the documented operation is a radical resection.
- 23066Shoulder biopsy
- 23066 reports biopsy of shoulder tissue for diagnostic sampling. It does not describe definitive radical tumor resection.
23078 billing questions
When should I choose 23078 instead of 23077?
Both describe radical resection of a shoulder-area tumor, but 23078 is for a tumor measuring 5 cm or larger. Code 23077 is for a tumor smaller than 5 cm.
How is 23078 different from 23073?
23078 represents radical resection of a tumor measuring at least 5 cm. Code 23073 describes excision of a deep shoulder tumor of that size, rather than radical resection.
What documentation supports reporting 23078?
The operative report should identify the shoulder-area tumor, document its size as at least 5 cm, and describe the extent of the radical resection.
Does the 90-day global period include postoperative visits?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
How is bilateral reporting handled?
When the procedure is performed bilaterally and reported with modifier 50, CMS pays 150% under the stated bilateral rule.
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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