Billing code 23035: Bone incisionMedicare rate & RVUs in Utah
Reports an operative incision through shoulder-area bone cortex, typically to treat or investigate osteomyelitis or a bone abscess.
CMS doesn’t publish an office rate for 23035 in Utah.
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 23035 covers
An orthopedic surgeon uses this service when the operative target is bone in the shoulder area and the cortex must be incised, such as to address osteomyelitis or a bone abscess. The work is performed in an operative setting; it is distinct from opening a deep shoulder soft-tissue abscess or an infected bursa when the bone cortex is not the target.
Report the code when the operative note identifies the shoulder-area bone and documents the cortical incision and its purpose. This major surgery code 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are 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.
23035 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $611.86 |
How the 23035 rate is calculated
Each of 23035’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 · 23035
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.93Practice expense 8.23Malpractice 1.84
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23035
23035 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23035
Bone incision
| 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) | 0 | Not permitted. |
| 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 · 23035
Bone incision
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
23035 without 50 · national facility
$634.62
Bone incision
23035-50 · Bilateral: 150%
$951.93
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).
23035 compared with similar codes
Compare codes
23035 vs 23030 vs 23031 vs 23065 vs 23066: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23030Shoulder drainage
- 23030 addresses a deep shoulder or axillary soft-tissue abscess or hematoma. Choose 23035 when the operative work includes incision of the shoulder-area bone cortex.
- 23031Bursa drainage
- 23031 is for drainage of an infected shoulder bursa. This code is for a cortical incision in shoulder-area bone.
- 23065Shoulder biopsy
- 23065 describes biopsy of superficial shoulder-area tissue. This code concerns an incision through bone cortex, not a superficial soft-tissue biopsy.
- 23066Shoulder biopsy
- 23066 describes biopsy of deep shoulder-area tissue. Select this code when the documented service is incision of bone cortex instead.
23035 billing questions
How does this differ from 23030?
Use 23035 when the surgeon incises the shoulder-area bone cortex. Code 23030 describes drainage of a deep abscess or hematoma in shoulder or axillary soft tissue.
Is an infected shoulder bursa reported with this code?
When the operative target is an infected bursa, 23031 describes that service. This code is for incision of bone cortex, not bursal drainage.
What should the operative note document?
Document the shoulder-area bone treated, the cortical incision, and the clinical purpose, such as treatment of osteomyelitis or a bone abscess.
Can modifier 50 be used for bilateral procedures?
Yes. CMS payment for bilateral reporting with modifier 50 is 150%.
What global and assistant-surgery rules apply?
The code has a 90-day global period that includes the day-before preoperative visit and related postoperative care. An assistant at surgery may be paid, but 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 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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