CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 23455 RVU and Medicare Payment (2026)
Repair shoulder capsule — 14.3 work RVU, about $880.45 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 14.3
- PE RVU (non-facility)
- 9.33
- PE RVU (facility)
- 9.33
- MP RVU
- 2.73
- Office payment
- $880.45
- Facility payment
- $880.45
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 23455 in a non-facility setting with national GPCI: (14.3 + 9.33 + 2.73) × $33.4009 ≈ $880.45. The same code in a facility setting pays about $880.45 because facility PE RVU (9.33) replaces office PE RVU.
What changes by locality
GPCI moves 23455 non-facility payment from $792.28 to $1,098.58 across CMS localities — from Arkansas to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 23455?
14.3. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 23455 in 2026?
About $880.45 non-facility ($880.45 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (14.3) and malpractice RVU stay fixed; only practice expense changes (9.33 office vs 9.33 facility). That is the entire office-vs-facility payment gap.