Surgical removal of a foreign body from the subcutaneous tissue of the shoulder, performed as an open procedure.

Verified May 8, 2026 · 6 sources ↓

Medicare: $328.33
Work RVU: 1.85
Global, days: 10
Region: Shoulder

Drawn from CMSAAPCMdclarityFindacodeAAOS

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify the nature and description of the foreign body (e.g., metal fragment, glass shard, organic material)
Document the anatomic depth — confirm subcutaneous tissue versus deeper planes to justify code selection
Record laterality explicitly (left, right, or bilateral) in the operative note and on the claim
Note any complicating factors — scarring, proximity to neurovascular structures, prior attempts — if billing modifier 22
Include the surgical approach and closure technique to satisfy operative report standards

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 23330 covers open removal of a foreign body — metal fragments, glass, or other debris — lodged in the subcutaneous tissue of the shoulder. This is a straightforward open excision, not an arthroscopic procedure. If the foreign body is deep to subcutaneous tissue or requires arthroscopic retrieval, a different code applies.

The global period is 010 (10-day), meaning routine follow-up through the first 10 postoperative days is bundled into the payment. Any E/M visit during that window for an unrelated problem needs modifier 24; a significant, separately identifiable visit needs modifier 25 appended to the E/M code on the day of surgery.

Side laterality matters: append LT or RT on every claim. Bilateral same-session removal — uncommon but possible — requires modifier 50. If the retrieval is substantially more complex than typical (dense scarring, proximity to neurovascular structures, prior failed attempts), modifier 22 requires documentation explicitly describing why the work exceeded standard.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (1.85) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (9.83) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	1.85
Practice expense RVU	7.58
Malpractice RVU	0.4
Total RVU	9.83
Medicare national rate	$328.33
Global period	10 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

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$328.33
HOPD (APC 5072) Hospital outpatient department	$1,687.37
ASC (PI A2) Ambulatory surgical center (freestanding)	$742.04

Common denial reasons

The recurring reasons claims for CPT 23330 get rejected.

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

Missing laterality modifier (LT or RT) — many payers auto-deny shoulder codes without a side designator
ICD-10 diagnosis code mismatch — the foreign body diagnosis must correspond to the shoulder region and match clinical documentation
Claim submitted during a global period from a prior shoulder procedure without an appropriate modifier (24, 25, 78, or 79)
Insufficient documentation to support modifier 22 when billed — operative note must explicitly describe the added complexity

Frequently asked questions

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

01What is the global period for CPT 23330?

10-day global (010). Routine post-op visits within those 10 days are bundled. Bill E/M services for unrelated problems in that window with modifier 24.

02Do I need a laterality modifier for 23330?

Yes — always append LT or RT. Most payers deny shoulder procedure claims that arrive without a side designator, and it's among the top reasons for 23330 rejections.

03When should I use 23330 versus the arthroscopic foreign body removal code 29819?

Use 23330 for open removal from subcutaneous tissue. Use 29819 when the surgeon performs arthroscopic retrieval; that code has its own documentation requirement — the loose body must be at least as large as the arthroscopic cannula diameter and require a separate incision or enlarged portal.

04Can I bill modifier 22 if the retrieval was unusually difficult?

Yes, but documentation must carry the weight. The operative note needs to explicitly describe what made the case harder — dense fibrosis, proximity to the brachial plexus, prior failed extractions. A generic reference to 'difficult removal' won't survive audit.

05If the patient had shoulder surgery two months ago and now needs foreign body removal, what modifier applies?

If the foreign body removal is unrelated to the prior procedure, use modifier 79 on 23330. If it is related to the prior surgery — for example, a retained surgical instrument — use modifier 78, which signals an unplanned return for a related procedure in the postoperative period.

06Is 23330 payable in an ASC setting?

Yes. CMS assigns a separate ASC payment rate for 23330. See the Site of Service comparison table on this page for the current facility and non-facility amounts under the 2026 Physician Fee Schedule.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the foreign body description, confirmed anatomic depth (subcutaneous versus deeper), laterality, and any complicating factors dictated intraoperatively. That prevents the two most common denials for 23330: missing LT/RT and a diagnosis-to-procedure mismatch when depth or location aren't specified in the note.

See how Mira captures CPT 23330 documentation