{
    "code": "23430",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/23430/2016/A",
    "release_specific_url": "https://localishealth.com/cpt/23430/2016/D",
    "description": "Open shoulder surgery to detach the long head of the biceps tendon from its frayed attachment inside the shoulder joint and reattach it lower down on the upper arm bone. Moving the anchor point out of the joint removes a common source of front-of-shoulder pain while keeping the muscle working. This is the open version; the same reattachment done through arthroscopic portals is coded differently.",
    "answer": {
        "question": "How much did Medicare pay for CPT 23430 in Q4 2016?",
        "text": "Medicare paid $767.29 for CPT 23430 in the office (non-facility) setting and $767.29 in a facility under the Q4 2016 Physician Fee Schedule, effective October 2016. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2016, when it decreased 0.6%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2016,
        "quarter": "D",
        "label": "Q4 2016",
        "effective": "October 1 – December 31, 2016",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 767.29,
        "facility": 767.29,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 10.17,
        "practice_expense_non_facility": 9.28,
        "practice_expense_facility": 9.28,
        "malpractice": 1.98
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.8043,
    "source": {
        "label": "Physician relative value file (Q4 2016)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu16d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2016/D",
        "file": "PPRRVU16_V0804.csv",
        "row": 5866,
        "sha256": "376b12d2df1b1c1abaed1e123e9501352bf559c75a0a4f87f52878742af491c9"
    },
    "modified_at": "2026-08-04T03:07:13+00:00"
}