{
    "code": "23472",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/23472/2019/A",
    "release_specific_url": "https://localishealth.com/cpt/23472/2019/B",
    "description": "Replacement of both sides of the ball-and-socket shoulder joint: the top of the upper arm bone and the socket on the shoulder blade are both resurfaced with implants. This covers conventional total shoulder replacement as well as the reverse design, in which the ball and socket are swapped so the deltoid muscle can power the arm when the rotator cuff no longer can. It is distinguished from partial replacement, where only the arm-bone side is replaced.",
    "answer": {
        "question": "How much did Medicare pay for CPT 23472 in Q2 2019?",
        "text": "Medicare paid $1,511.12 for CPT 23472 in the office (non-facility) setting and $1,511.12 in a facility under the Q2 2019 Physician Fee Schedule, effective April 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2019, when it decreased 0.1%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2019,
        "quarter": "B",
        "label": "Q2 2019",
        "effective": "April 1 – June 30, 2019",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 1511.12,
        "facility": 1511.12,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 22.13,
        "practice_expense_non_facility": 15.57,
        "practice_expense_facility": 15.57,
        "malpractice": 4.23
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0391,
    "source": {
        "label": "Physician relative value file (Q2 2019)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19b.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2019/B",
        "file": "PPRRVU19_APR.csv",
        "row": 6396,
        "sha256": "b427bbfdcb61b355ba034840681873d1bd6cdcf51752bdae1bab7c5449efc971"
    },
    "modified_at": "2026-08-04T03:08:53+00:00"
}