Billing code 23106: Joint surgeryMedicare rate & RVUs in Utah
Reports open removal of diseased synovial tissue from the sternoclavicular joint, such as for persistent synovitis requiring operative treatment.
CMS doesn’t publish an office rate for 23106 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 23106 covers
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.
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 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $468.90 |
How the 23106 rate is calculated
Each of 23106’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 · 23106
RVUs × geographic indexes × conversion factor
Work5.98
5.98 RVUs× 1.000 GPCI
Practice expense7.35
7.35 RVUs× 1.000 GPCI
Malpractice1.28
1.28 RVUs× 1.000 GPCI
Adjusted RVUs
14.6100
Conversion factor
$33.4009
Medicare rate
$487.99
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23106
23106 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23106
Joint surgery
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 23106
Joint surgery
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
23106 without 50 · national facility
$487.99
Joint surgery
23106-50 · Bilateral: 150%
$731.99
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).
23106 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23101Joint arthrotomy
- This code is for sternoclavicular synovectomy. Code 23101 is the biopsy-focused arthrotomy option for the sternoclavicular or acromioclavicular joint.
- 23105Shoulder synovectomy
- Both involve open synovectomy, but 23105 applies to the glenohumeral joint; 23106 applies to the sternoclavicular joint.
- 23120Clavicle resection
- Code 23120 removes part of the clavicle. Use 23106 for synovial-tissue removal at the sternoclavicular joint, not bone excision.
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 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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