{
    "code": "23430",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/23430/2021/A",
    "release_specific_url": "https://localishealth.com/cpt/23430/2021/B",
    "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 Q2 2021?",
        "text": "Medicare paid $767.30 for CPT 23430 in the office (non-facility) setting and $767.30 in a facility under the Q2 2021 Physician Fee Schedule, effective April 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2021, when it decreased 1.1%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2021,
        "quarter": "B",
        "label": "Q2 2021",
        "effective": "April 1 – June 30, 2021",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 767.3,
        "facility": 767.3,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 10.17,
        "practice_expense_non_facility": 9.89,
        "practice_expense_facility": 9.89,
        "malpractice": 1.93
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.8931,
    "source": {
        "label": "Physician relative value file (Q2 2021)",
        "cms_url": "https://www.cms.gov/files/zip/rvu21b-updated-03022021.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2021/B",
        "file": "PPRRVU21_APR.csv",
        "row": 6661,
        "sha256": "524bee7096166c9011a4ea02189783ef8c91f4d444585e5b2d561b879f9262de"
    },
    "modified_at": "2026-08-04T03:10:33+00:00"
}