CPT 23400
Global 090 ActiveFixation of shoulder blade
CPT 23400 Billing & Documentation Guide
CPT code 23400 (Fixation of shoulder blade) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 13.52, a non-facility practice expense RVU of 10.5, and a malpractice RVU of 2.89, a total non-facility RVU of 26.91 and facility RVU of 26.91. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $909.44, though rates vary from $802.55 to $1104.06 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 23400, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 23400 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 23400 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 23400
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 13.52 | 13.52 |
| Practice Expense RVU | 10.5 | 10.5 |
| Malpractice RVU | 2.89 | 2.89 |
| Total RVU | 26.91 | 26.91 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 23400
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $935.1 | $935.1 | $895.37 - $1058.72 | 29 |
| Florida | $991.37 | $991.37 | $931.94 - $1060.79 | 3 |
| Georgia | $902.34 | $902.34 | $879.48 - $925.19 | 2 |
| Illinois | $976.5 | $976.5 | $922.65 - $1028.74 | 4 |
| Michigan | $916.76 | $916.76 | $880.76 - $952.76 | 2 |
| North Carolina | $840.47 | $840.47 | $840.47 - $840.47 | 1 |
| New York | $995.48 | $995.48 | $852.61 - $1076.73 | 5 |
| Ohio | $869.08 | $869.08 | $869.08 - $869.08 | 1 |
| Pennsylvania | $902.36 | $902.36 | $864.75 - $939.96 | 2 |
| Texas | $889 | $889 | $860.4 - $936.27 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 23400
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 23400 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01610 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 23400
What does CPT code 23400 mean? +
CPT code 23400 represents: Fixation of shoulder blade. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 23400? +
The 2026 Medicare national average non-facility payment for CPT 23400 is $909.44. Rates range from $802.55 to $1104.06 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 23400? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 23400? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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