Billing code 23455: Shoulder stabilizationMedicare rate & RVUs in Utah

Open anterior shoulder stabilization that repairs the detached labrum and tightens the capsule, commonly performed for recurrent instability or dislocation.

CMS RVU26DEffective Oct 1, 20261 payment locality123 Medicare services in 2024

CMS doesn’t publish an office rate for 23455 in Utah.

—Office (non-facility)
$852.45Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 23455 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 23455 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 23455 covers

This open operation stabilizes the front of the shoulder by reattaching the labrum to the glenoid and tightening the capsule. Orthopedic surgeons commonly perform it for recurrent anterior shoulder instability, including instability after dislocation when the labrum and capsule are detached or lax. The repair is performed in an operating room, typically in a facility setting.

Report this code when the operative work includes both anterior capsular tightening and labral repair; a capsule-only repair is a different service. The operative report should document the instability, labral injury, approach, and repairs performed. The 90-day global period includes 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 others 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.

23455 in Utah

23455 office and facility rates by payment locality
Payment localityOfficeFacility
UtahUnavailable$852.45

How the 23455 rate is calculated

Each of 23455’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 · 23455

RVUs × geographic indexes × conversion factor

Work14.30

14.30 RVUs× 1.000 GPCI

Practice expense9.33

9.33 RVUs× 1.000 GPCI

Malpractice2.73

2.73 RVUs× 1.000 GPCI

Adjusted RVUs

26.3600

Conversion factor

$33.4009

Medicare rate

$880.45

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 23455

23455 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23455

Shoulder stabilization

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 23455

Shoulder stabilization

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

23455 without 50 · national facility

$880.45

Shoulder stabilization

23455-50 · Bilateral: 150%

$1,320.68

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).

When to use modifier 50

23455 compared with similar codes

Compare codes · National

5 codes, side by side

  • 23455

    Shoulder stabilization14.3 wRVU

    Not priced

  • 23450

    Shoulder stabilization13.36 wRVU

    Not priced

  • 23460

    Shoulder stabilization15.42 wRVU

    Not priced

  • 23462

    Shoulder stabilization15.33 wRVU

    Not priced

  • 29806

    Shoulder stabilization14.76 wRVU

    Not priced

How to choose

23450Shoulder stabilization
Use 23450 for anterior capsular repair without labral repair. This code includes repair of the anterior labrum as well as capsular tightening.
23460Shoulder stabilization
23460 involves a bone-block stabilization technique. This code describes anterior labral repair with capsular tightening, without that bone-block distinction.
23462Shoulder stabilization
23462 involves coracoid process transfer for stabilization. This code is the open anterior labral and capsular repair without that transfer.
29806Shoulder stabilization
29806 describes arthroscopic capsulorrhaphy. This code is used for the open anterior repair that includes labral reattachment.

23455 billing questions

How does this differ from 23450?

This code includes repair of the anterior labrum along with capsular tightening. Code 23450 describes anterior capsular repair without the labral repair.

Can the labral repair be billed separately?

The labral repair is part of this service. Do not report a separate code for that same repair.

When is 29806 considered instead?

Code 29806 describes arthroscopic shoulder capsulorrhaphy. This code represents the open anterior repair, so the documented surgical approach helps distinguish them.

What should the operative report support?

Document the anterior instability, the labral detachment or injury, and the open capsular and labral work performed. The record should make clear that both structures were repaired.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are bilateral procedures and assistants handled?

When performed bilaterally and reported with modifier 50, CMS pays at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation.

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
RVUs for 23455PPRRVU2026_Oct_nonQPP.csv, line 2,205 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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