Soft tissue repair · Shoulder

23073

Surgical removal of a deep (subfascial/intramuscular) soft-tissue tumor of the shoulder measuring 5 cm or greater in its greatest dimension.

Verified May 8, 2026 · 6 sources ↓

Medicare
$658.67
Total RVUs
19.72
Global, days
90
Region
Shoulder
Drawn from CMSFastrvuMdclarityAAPCFindacode

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 6 cited references ↓

  • Tumor depth confirmed as subfascial or intramuscular — state this explicitly in the operative note, not just 'deep dissection required'
  • Measured tumor size of 5 cm or greater, documented intraoperatively and reconciled with pathology report
  • Operative note describes the specific surgical approach and muscle layers traversed or reflected
  • Preoperative imaging (MRI preferred) characterizing tumor depth, size, and relationship to neurovascular structures
  • Pathology specimen submitted with laterality and anatomic site labeled; final path report retained in the record
  • ICD-10 diagnosis code reflecting whether the tumor is benign, uncertain behavior, or malignant — this must match the pre-op working diagnosis or be updated post-pathology

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 23073 covers open excision of a deep soft-tissue tumor in the shoulder area — subfascial or intramuscular — when the specimen measures 5 cm or more. These are substantial dissections: the surgeon must work through or beneath the muscle layer to achieve adequate margins, which is why the work RVU is nearly double that of its smaller-tumor counterpart. The 90-day global period applies, covering all routine post-op care through day 90.

Depth matters for code selection. If the tumor sits above the fascia, use 23071 (less than 5 cm) or 23075/23076 for superficial tumors — not 23073. Using 23073 on a superficial lesion is an audit target. Confirm depth in both the preoperative imaging read and the operative note.

Pathology submission is standard for tumors of this size. Document the specimen's measured dimensions — taken by the surgeon intraoperatively or confirmed on final pathology — because the 5 cm threshold is the billing threshold. A specimen that comes back at 4.8 cm on path creates a coding discrepancy you'll need to address.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU9.88
Practice expense RVU7.57
Malpractice RVU2.27
Total RVU19.72
Medicare national rate$658.67
Global period90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$658.67
HOPD (APC 5073)
Hospital outpatient department
$2,967.63
ASC (PI G2)
Ambulatory surgical center (freestanding)
$1,248.36

Common denial reasons

The recurring reasons claims for CPT 23073 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

  • Tumor size not documented at or above 5 cm — use 23071 if the lesion is deep but smaller than 5 cm
  • Depth not substantiated in operative note; payers deny 23073 when the note is consistent with a superficial excision
  • Missing or mismatched laterality — claims without LT or RT modifier are routinely flagged by commercial payers
  • ICD-10 diagnosis code inconsistent with the procedure (e.g., a benign lipoma code paired with a malignant-tumor workup note)
  • Unbundling of pathology handling or closure when those services are considered inclusive to the global excision

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What separates 23073 from 23071?
Both are deep shoulder tumor excisions, but 23073 requires a specimen measuring 5 cm or greater. Use 23071 when the deep tumor is less than 5 cm. The size threshold is the only differentiator between these two codes.
02Do I need LT or RT every time?
Most commercial payers and Medicare require laterality modifiers on shoulder procedures. Apply LT or RT on every claim for 23073. Omitting them is a common clean-claim failure that delays payment.
03Can I bill modifier 22 if the dissection was unusually complex?
Yes, but you need documentation to support it — operative note must describe the specific factors that increased complexity (e.g., proximity to neurovascular bundle, extensive adhesions, prior surgery). Modifier 22 without supporting documentation will be denied or ignored.
04What happens if pathology returns a size below 5 cm?
If the final pathology measurement falls below 5 cm, you have a coding discrepancy. Some practices rebill with 23071 and a corrected claim; others document the intraoperative measurement to justify the original code. The intraoperative dimension is the operative measurement of record — but reconcile any significant discrepancy in the chart.
05Is 23073 billable in an ASC setting?
Yes. The code is payable in both the HOPD and ASC settings under CMS, though ASC payment is substantially lower than HOPD payment — see the site-of-service comparison on this page.
06Can an assistant surgeon bill for this procedure?
Yes. Assistant surgeon services (modifier 80 for an MD/DO, or AS for a physician assistant or nurse practitioner) are recognized for 23073. Confirm assistant surgeon allowance with the individual payer, as some commercial plans restrict it.
07What is the global period for 23073?
90 days. All routine post-op care from the day before surgery through day 90 is included. Bill unrelated E/M visits during that window with modifier 24, and unrelated procedures with modifier 79. A staged or related return to the OR uses modifier 58 (planned) or 78 (unplanned, related complication).

Mira AI Scribe

Mira's AI scribe captures tumor depth (subfascial vs. intramuscular), intraoperative measurement, the specific muscle layers dissected, and specimen laterality directly from dictation. This prevents the most common denial trigger for 23073 — an operative note that establishes size but fails to document subfascial depth, which downcodes the claim to a superficial excision code.

See how Mira captures CPT 23073 documentation

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