CPT 23410
Global 090 ActiveRepair rotator cuff acute
CPT 23410 Billing & Documentation Guide
CPT code 23410 (Repair rotator cuff acute) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 11.11, a non-facility practice expense RVU of 9.49, and a malpractice RVU of 2.3, a total non-facility RVU of 22.9 and facility RVU of 22.9. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $775.23, though rates vary from $682.93 to $936.53 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 23410, 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 23410 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 23410 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 23410
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 11.11 | 11.11 |
| Practice Expense RVU | 9.49 | 9.49 |
| Malpractice RVU | 2.3 | 2.3 |
| Total RVU | 22.9 | 22.9 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 23410
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 | $801.11 | $801.11 | $765.97 - $910.16 | 29 |
| Florida | $838.66 | $838.66 | $789.58 - $895.34 | 3 |
| Georgia | $765.95 | $765.95 | $745.4 - $786.51 | 2 |
| Illinois | $825.46 | $825.46 | $780.55 - $868.55 | 4 |
| Michigan | $776.85 | $776.85 | $747.21 - $806.49 | 2 |
| North Carolina | $715.91 | $715.91 | $715.91 - $715.91 | 1 |
| New York | $846.74 | $846.74 | $726.22 - $914.37 | 5 |
| Ohio | $737.92 | $737.92 | $737.92 - $737.92 | 1 |
| Pennsylvania | $767.02 | $767.02 | $734.66 - $799.38 | 2 |
| Texas | $756.55 | $756.55 | $730.9 - $794.52 | 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 23410
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 23410 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 23410
What does CPT code 23410 mean? +
CPT code 23410 represents: Repair rotator cuff acute. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 23410? +
The 2026 Medicare national average non-facility payment for CPT 23410 is $775.23. Rates range from $682.93 to $936.53 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 23410? +
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 23410? +
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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