Billing code 23107: Shoulder arthrotomyMedicare rate & RVUs in Washington
Open glenohumeral joint exploration covers surgical inspection, drainage, or foreign-body removal when the shoulder joint requires direct operative access.
CMS doesn’t publish an office rate for 23107 in Washington.
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 23107 covers
This service involves opening the glenohumeral joint for direct inspection, drainage, or removal of a foreign body. An orthopedic surgeon typically performs it in an operating room, such as when shoulder joint pathology requires open access rather than inspection through an arthroscope. The operative report should identify the joint and document the work performed through the arthrotomy.
Report 23107 when the documented service is open exploration, drainage, or foreign-body removal—not a joint biopsy or synovectomy coded to a more specific procedure. The 90-day global period 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons are paid only with 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.
Where 23107 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $630.35 |
| Seattle (King Cnty) | Unavailable | $692.64 |
How the 23107 rate is calculated
Each of 23107’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 · 23107
RVUs × geographic indexes × conversion factor
Work8.65
8.65 RVUs× 1.000 GPCI
Practice expense8.30
8.30 RVUs× 1.000 GPCI
Malpractice1.80
1.80 RVUs× 1.000 GPCI
Adjusted RVUs
18.7500
Conversion factor
$33.4009
Medicare rate
$626.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23107
23107 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23107
Shoulder arthrotomy
| 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) | 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 · 23107
Shoulder arthrotomy
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
23107 without 50 · national facility
$626.27
Shoulder arthrotomy
23107-50 · Bilateral: 150%
$939.41
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).
23107 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23100Shoulder arthrotomy
- Choose 23100 when an open glenohumeral arthrotomy includes biopsy. Choose 23107 for exploration, drainage, or foreign-body removal.
- 23105Shoulder synovectomy
- 23105 describes open glenohumeral arthrotomy with synovectomy; 23107 describes exploration, drainage, or foreign-body removal.
- 29805Shoulder arthroscopy
- 29805 is diagnostic shoulder arthroscopy, performed with a scope. 23107 involves open access to the glenohumeral joint.
23107 billing questions
How does 23107 differ from 23100?
23107 describes open joint exploration, drainage, or foreign-body removal. 23100 is for an arthrotomy that includes a joint biopsy.
When is 23105 a better fit?
Use 23105 when the documented open procedure includes synovectomy. 23107 describes exploration, drainage, or foreign-body removal.
Can the drainage or foreign-body removal be billed separately?
Those services are included in the scope of 23107 when performed through the arthrotomy. The operative note should specify which work was done.
How is a bilateral procedure reported?
CMS identifies 23107 as a bilateral procedure; modifier 50 is paid at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is 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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