$459.03
Choose 23031 for drainage of an infected shoulder bursa; choose 23030 when the treated finding is a deep shoulder abscess or hematoma.
On this page
CMS RVU26D · Effective 2026-10-01
23031 Bursa drainage Medicare reimbursement rates in Vermont
Open drainage of an infected shoulder bursa is reported when the surgeon treats infection in the bursa rather than a deeper shoulder abscess or joint. Compare 23031 office and facility rates across CMS payment localities in Vermont.
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 23031 in Vermont?
Vermont 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
$451.98
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$205.31
1 of 1 localities have a supported rate.
Payment area: Vermont
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 23031: Shoulder infected bursa drainage
Open drainage of an infected shoulder bursa is reported when the surgeon treats infection in the bursa rather than a deeper shoulder abscess or joint.
The surgeon opens the infected bursa in the shoulder region and drains its contents. An orthopedic surgeon typically performs this procedure in a hospital or other surgical setting when an infected bursa requires operative drainage. The key distinction is the treated structure: the target is the bursa, not a deep shoulder abscess or hematoma, bone, or shoulder joint.
Report the code when the operative documentation identifies an infected shoulder bursa and describes its incision and drainage. The code has a 10-day global period, so related postoperative visits during that period are included. 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. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 23031
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.72 · 20%
- Practice expense (office) RVU10.63 · 76%
- Malpractice RVU0.57 · 4%
82
Medicare services in 2024 · #5023 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.
23031 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Code 23040 concerns an arthrotomy of the glenohumeral joint, including exploration or drainage. This code is for an infected bursa.
No office rate
Code 23044 concerns arthrotomy of the acromioclavicular joint. Use this code when the operative target is an infected shoulder bursa instead.
Compare 23031 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
Vermont →
Office / nonfacility
$451.98
Facility
$205.31
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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 23031 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,151
- Code
- 23031
- Physician work
- 2.72
- Practice expense
- 10.63
- Malpractice
- 0.57
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.72 | × 1.000 | 2.7200 |
| Practice expense | 10.63 | × 0.990 | 10.5237 |
| Malpractice | 0.57 | × 0.506 | 0.2884 |
| Total RVUs | 13.5321 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$451.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.72 | 1 |
| Practice expense | 10.63 | 0.99 |
| Malpractice | 0.57 | 0.506 |
(2.72 × 1 + 10.63 × 0.99 + 0.57 × 0.506) × $33.4009 = $451.98
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.72 | 1 |
| Practice expense | 3.17 | 0.99 |
| Malpractice | 0.57 | 0.506 |
(2.72 × 1 + 3.17 × 0.99 + 0.57 × 0.506) × $33.4009 = $205.31
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.
23031 billing questions
How is this different from 23030?
Use 23031 when the surgeon drains an infected shoulder bursa. Code 23030 is for a deep shoulder abscess or hematoma, not an infected bursa.
Is drainage of the shoulder joint reported with this code?
No. This code identifies drainage of an infected bursa. When the procedure instead treats the glenohumeral joint, consider the shoulder arthrotomy code 23040.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure.
How is bilateral treatment paid?
CMS lists this as a bilateral procedure; modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports this code?
Document that the treated structure is an infected shoulder bursa and describe the operative incision and drainage. The record should distinguish the bursa from a deep abscess, hematoma, or joint infection.
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.
2,14823000,,Rmvl sbdltd clcreous dep opn,A,,4.37,12.04,,4.99,,0.70,17.11,10.06,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14923020,,Capsular contracture release,A,,9.13,8.44,NA,8.44,,1.91,19.48,19.48,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15023030,,I&d shoulder deep absc/hmtma,A,,3.38,10.11,,3.22,,0.70,14.19,7.30,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15123031,,I&d shoulder infected bursa,A,,2.72,10.63,,3.17,,0.57,13.92,6.46,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15223035,,Incision bone cortex sho,A,,8.93,8.23,NA,8.23,,1.84,19.00,19.00,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15323040,,Arthrt gh jt expl/drg/rmv fb,A,,9.51,8.68,NA,8.68,,1.96,20.15,20.15,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,15423044,,Arthrt ac sc jt exp/rmvl fb,A,,7.40,7.22,NA,7.22,,1.64,16.26,16.26,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817