CPT 23330Surgery

Remove shoulder foreign body

CPT code 23330 covers the surgical removal of a foreign object from the shoulder area. This includes removing items like metal fragments, glass, wood splinters, or other materials embedded in shoulder tissue.

Showing rates for

National Average

Base Medicare rate

$292.09

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.9

PE RVU (NF)

6.74

MP RVU

0.39

Total RVU

9.03

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify setting of service carefully - billing in facility vs non-facility setting creates a $125.18 difference in Medicare reimbursement for code 23330
Impact: Correct place of service code prevents automatic downcoding and secures appropriate reimbursement tier
Document imaging confirmation (X-ray, CT, ultrasound) showing foreign body location and depth before procedure to establish medical necessity
Impact: Pre-operative imaging documentation reduces denial risk by approximately 35% and supports appeals for modifier 22 when complexity is increased
Do not confuse 23330 with simple wound exploration (20103) or superficial foreign body removal from skin (10120-10121); 23330 requires deeper dissection into shoulder structures
Impact: Proper code differentiation prevents downcoding from $292.09 to $76-115 range for simpler procedures
When multiple foreign bodies are removed from the same shoulder during one session, bill 23330 only once; do not append modifier 51 for each object
Impact: Prevents claim rejection and avoids triggering audit flags for inappropriate multiple procedure billing
Capture operative time and detailed description of foreign body composition, size, depth, and anatomical relationships in operative note to support medical necessity
Impact: Comprehensive documentation supports modifier 22 appeals which can increase payment by $58-146 per case for complex removals
Check for workers' compensation or third-party liability before billing Medicare; shoulder foreign body removals often result from workplace or liability incidents with higher reimbursement rates

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 23330 in 2025?

The 2025 Medicare national average reimbursement for CPT 23330 is $292.09 for non-facility settings and $166.91 for facility settings. The work RVU is 1.9 with total RVUs of 9.03 based on the CMS Physician Fee Schedule.

What is the difference between CPT 23330 and 10120 for foreign body removal?

CPT 23330 is specifically for removing foreign bodies from the shoulder region requiring deeper dissection into shoulder structures, muscles, or soft tissues. CPT 10120 is for simple removal of foreign bodies from subcutaneous tissue anywhere on the body and involves only superficial layers. Code 23330 reimburses at $292.09 compared to approximately $115 for 10120, reflecting the increased complexity.

Can CPT 23330 be billed bilaterally with modifier 50?

Yes, if foreign bodies are removed from both shoulders during the same operative session, modifier 50 can be appended to CPT 23330. This increases reimbursement to 150% of the allowed amount, or approximately $438.14 for non-facility settings under 2025 Medicare rates.

What documentation is required to bill CPT 23330 successfully?

Required documentation includes pre-operative imaging confirming the foreign body location and depth, a detailed operative note describing tissue dissection and anatomical structures encountered, specific foreign body description (size, composition, depth), laterality specification, and medical necessity justification. Lack of imaging or vague operative notes are common denial triggers.

Does CPT 23330 have a global period?

Yes, CPT 23330 has a 90-day global surgical period. This means routine post-operative care within 90 days is included in the reimbursement. If additional procedures are needed during this period, modifiers 78 (related) or 79 (unrelated) must be used depending on the nature of the subsequent procedure.

When should modifier 22 be used with CPT 23330?

Modifier 22 should be appended when the foreign body removal requires significantly greater work than typical cases, such as deeply embedded objects near neurovascular structures, extensive dissection, prolonged operative time, or unusual anatomical challenges. Documentation must detail the additional complexity, and modifier 22 can increase reimbursement by 20-50% (approximately $58-146) if approved.

Can CPT 23330 be billed with an E/M service on the same day?

Yes, but modifier 25 must be appended to the E/M code to indicate a significant, separately identifiable service beyond the decision for surgery. The E/M must address issues beyond the foreign body itself, such as comprehensive trauma evaluation or assessment of other injuries. Without proper documentation and modifier 25, the E/M will typically be bundled and denied.