No office rate
Use 23156 when the humeral cyst or benign tumor is excised or curetted and the defect is filled with allograft. Use 23150 for the corresponding service without graft.
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CMS RVU26D · Effective 2026-10-01
23156 Bone lesion surgery Medicare reimbursement rates in Utah
Reports excision or curettage of a humeral bone cyst or benign tumor when the surgeon fills the resulting defect with allograft. Compare 23156 office and facility rates across CMS payment localities in Utah.
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 23156 in Utah?
Utah 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
$619.21
1 of 1 localities have a supported rate.
Payment area: Utah
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 23156: Humeral lesion curettage with allograft
Reports excision or curettage of a humeral bone cyst or benign tumor when the surgeon fills the resulting defect with allograft.
An orthopedic surgeon typically performs this open procedure in an operating room to remove or curette a bone cyst or benign tumor in the humerus and fill the resulting defect with donor bone graft. The treatment may address a lesion in the upper arm bone that needs surgical removal and graft reconstruction; the operative report should identify the humeral site, lesion, removal method, and use of allograft.
Choose this code when the humeral lesion is treated by excision or curettage with allograft, rather than selecting a code for a different graft method or no graft. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are not permitted.
CMS billing rules for 23156
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.88 · 46%
- Practice expense (office) RVU8.46 · 44%
- Malpractice RVU1.90 · 10%
12
Medicare services in 2024 · #6139 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.
23156 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
Both describe humeral lesion treatment with grafting, but 23155 specifies autograft and 23156 specifies allograft.
No office rate
23184 describes partial excision of proximal humerus. Choose 23156 for curettage or excision of a bone cyst or benign tumor with allograft.
Compare 23156 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
Utah →
Office / nonfacility
Unavailable
Facility
$619.21
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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 23156 in Utah.
PPRRVU2026_Oct_nonQPP.csv
2,176
- Code
- 23156
- Physician work
- 8.88
- Practice expense
- 8.46
- Malpractice
- 1.90
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.88 | × 1.000 | 8.8800 |
| Practice expense | 8.46 | × 0.940 | 7.9524 |
| Malpractice | 1.90 | × 0.898 | 1.7062 |
| Total RVUs | 18.5386 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$619.21
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.88 | 1 |
| Practice expense | 8.46 | 0.94 |
| Malpractice | 1.9 | 0.898 |
(8.88 × 1 + 8.46 × 0.94 + 1.9 × 0.898) × $33.4009 = $619.21
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.
23156 billing questions
How does 23156 differ from 23150?
23156 describes humeral cyst or benign-tumor excision or curettage with allograft. 23150 is the corresponding humeral service without graft.
How does 23156 differ from 23155?
The distinction is the graft source: 23156 uses allograft, while 23155 uses autograft.
Is the allograft part of the reported service?
Yes. Allograft use is the distinguishing feature of 23156; do not also report 23150 for the same lesion treatment.
What documentation supports reporting 23156?
Document the humeral lesion and its location, the excision or curettage performed, and that allograft was used to fill the defect.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
Can 23156 be reported for bilateral humeral lesions?
For bilateral treatment, modifier 50 is paid at 150% under the CMS facts for this code.
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.
2,17323146,,Removal of bone lesion,A,,7.88,8.29,NA,8.29,,1.68,17.85,17.85,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17423150,,Removal of humerus lesion,A,,8.69,8.40,NA,8.40,,1.85,18.94,18.94,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17523155,,Removal of humerus lesion,A,,10.59,9.57,NA,9.57,,2.25,22.41,22.41,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17623156,,Removal of humerus lesion,A,,8.88,8.46,NA,8.46,,1.90,19.24,19.24,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17723170,,Sequestrectomy clavicle,A,,7.03,7.68,NA,7.68,,1.48,16.19,16.19,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17823172,,Sequestrectomy scapula,A,,7.13,7.71,NA,7.71,,1.50,16.34,16.34,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17923174,,Sqstrctmy humrl head srg nck,A,,9.80,9.81,NA,9.81,,2.09,21.70,21.70,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985