{"id":183386,"date":"2026-08-18T12:04:12","date_gmt":"2026-08-18T12:04:12","guid":{"rendered":"https:\/\/pabau.com\/?p=183386"},"modified":"2026-08-18T12:54:38","modified_gmt":"2026-08-18T12:54:38","slug":"cpt-code-23073","status":"publish","type":"post","link":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-23073\/","title":{"rendered":"CPT code 23073: Shoulder soft tissue tumor excision guide"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 23073: Shoulder Soft Tissue Tumor Excision Billing Guide\",\"description\":\"Complete billing reference for CPT Code 23073 (excision of subfascial soft tissue tumor of the shoulder area, 5 cm or greater). Covers reimbursement, RVUs, modifiers, ICD-10 codes, and documentation requirements.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-23073\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-10\",\"dateModified\":\"2026-08-18\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT code 23073 covers excision of a subfascial soft tissue tumor of the shoulder area. The specimen must measure 5 cm or greater.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The closest miscode is 23076, which covers the same subfascial depth for tumors under 5 cm. Only the measurement separates the two.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>23071 and 23075 are subcutaneous codes that split at 3 cm, so picking either one for a subfascial tumor is a depth error.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Radical resection is a separate pair of codes. 23077 covers tumors under 5 cm, and 23078 covers 5 cm or greater.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The 90-day global period means post-operative follow-up visits within 90 days cannot be billed separately without an applicable modifier.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Claims management software like Pabau links CPT codes, modifiers, and ICD-10 codes inside a single documentation workflow.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT code 23073 covers the surgical excision of a subfascial soft tissue tumor of the shoulder area. The specimen must measure 5 cm or greater in its greatest dimension.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">American Medical Association (AMA)<\/a> publishes the CPT code set. Code 23073 sits in the Shoulder subsection (23000-23929) of the Musculoskeletal System chapter (20100-29999), under Excision Procedures on the Shoulder.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The code most often confused with it is 23076, which covers the same subfascial depth below 5 cm. The measurement recorded in the operative note is what separates the two.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-cpt-23073-full-description-and-classification\" class=\"wp-block-heading\">CPT 23073 full description and classification<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The subfascial designation is the critical clinical differentiator. It means the tumor lies below the fascia, typically within muscle tissue, rather than in the subcutaneous layer above it. Imaging findings, intraoperative findings, and the pathology report all establish that depth, and all three belong in the operative note.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Full AMA description:<\/strong> &#8220;Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater&#8221;<\/li>\n\n\n\n<li><strong>CPT code range:<\/strong> Shoulder subsection, 23000-23929, within the Musculoskeletal System chapter (20100-29999)<\/li>\n\n\n\n<li><strong>Subsection:<\/strong> Excision Procedures on the Shoulder<\/li>\n\n\n\n<li><strong>Size threshold:<\/strong> Greatest dimension must be 5 cm or greater at time of excision<\/li>\n\n\n\n<li><strong>Depth:<\/strong> Subfascial (below the fascia), including intramuscular tumors<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Common clinical examples include intramuscular lipomas of the deltoid or rotator cuff musculature. The code also covers deep soft tissue sarcomas of the shoulder girdle. Any large subfascial mass removed by open excision belongs here.<\/p>\n\n\n\n<h2 id=\"h-clinical-criteria-and-documentation-requirements\" class=\"wp-block-heading\">Clinical criteria and documentation requirements<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Payers consistently flag 23073 claims that lack explicit documentation of depth and size. The operative note needs more than a narrative description of depth. Pre-operative imaging should corroborate it, and the intraoperative findings should confirm it.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/blog\/hipaa-compliance-for-medical-offices\/\">HIPAA-compliant documentation<\/a> means storing every supporting record in a <a href=\"https:\/\/pabau.com\/features\/medical-records-management\/\">structured clinical record<\/a> that links back to the billed procedure code. MRI reports, pathology results, and operative notes all belong in the same file, because auditors expect to find them together.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-23073\/comprehensive-patient-records.webp\" alt=\"Comprehensive patient records\"\/><figcaption class=\"wp-element-caption\"><em>A single client record holds the patient&#8217;s identifiers next to every follow-up, so the operative note and the claim point at the same file.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Tumor size:<\/strong> Greatest dimension must be documented as 5 cm or greater, from pre-op imaging or intraoperative measurement<\/li>\n\n\n\n<li><strong>Tumor depth:<\/strong> Explicitly state &#8220;subfascial&#8221; or &#8220;intramuscular&#8221; in the operative report, because &#8220;deep&#8221; alone is insufficient<\/li>\n\n\n\n<li><strong>Anatomical location:<\/strong> Specify the shoulder region (deltoid, supraspinatus, infraspinatus, etc.) and laterality<\/li>\n\n\n\n<li><strong>Imaging correlation:<\/strong> MRI or ultrasound findings confirming subfascial location should be referenced<\/li>\n\n\n\n<li><strong>Pathology report:<\/strong> Final pathology confirming the nature of the excised tumor (benign vs. malignant) is expected by most payers<\/li>\n\n\n\n<li><strong>Medical necessity:<\/strong> Clinical indication for excision, such as impingement confirmed on <a href=\"https:\/\/pabau.com\/blog\/neers-test\/\">Neer&#8217;s test<\/a>, suspected malignancy, or growth trajectory<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Missing any of these elements leaves the claim open to a documentation request or an outright denial. A depth documentation failure is the most common reason 23073 is downgraded to 23071, the subcutaneous code.<\/p>\n\n\n\n<h2 id=\"h-how-23073-differs-from-23076-23071-and-23078\" class=\"wp-block-heading\">How 23073 differs from 23076, 23071, and 23078<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The shoulder soft tissue tumor family turns on two axes, tissue depth and tumor size. A third axis, surgical extent, separates standard excision from radical resection. This is where upcoding and downcoding errors most commonly occur.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Procedure<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Tissue depth<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Size<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Surgical extent<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">23075<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Excision, soft tissue tumor, shoulder area<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subcutaneous (above fascia)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Less than 3 cm<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Standard excision<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">23071<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Excision, soft tissue tumor, shoulder area<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subcutaneous (above fascia)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">3 cm or greater<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Standard excision<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">23076<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Excision, soft tissue tumor, shoulder area<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subfascial \/ intramuscular<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Less than 5 cm<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Standard excision<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">23073<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Excision, soft tissue tumor, shoulder area<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subfascial \/ intramuscular<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5 cm or greater<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Standard excision<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">23077<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Radical resection, soft tissue tumor, shoulder area<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Any depth<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Less than 5 cm<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Wide-margin en-bloc resection<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">23078<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Radical resection, soft tissue tumor, shoulder area<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Any depth<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5 cm or greater<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Wide-margin en-bloc resection<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">23076 is the code most often confused with 23073. Both cover subfascial excision in the shoulder area, and only the measurement separates them. A tumor under 5 cm codes to 23076, and one of 5 cm or greater codes to 23073.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">23071 and 23075 sit above the fascia, and they split at 3 cm rather than 5 cm. Choosing either one for a subfascial tumor means the dissection plane was read wrong, not the tape measure.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Radical resection is a separate pair of codes. 23077 covers tumors under 5 cm, and 23078 covers tumors of 5 cm or greater. The radical resection counterpart of 23073 at the same size threshold is 23078, not 23077.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Radical resection means wide-margin en-bloc removal of surrounding tissue to achieve oncologic margins, and it is typically reserved for malignant or potentially malignant tumors. Standard excision under 23073 suits well-defined tumors where clean margins need no sacrifice of surrounding structures.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Billing 23078 when 23073 was actually performed is upcoding. The operative note has to describe the wide-margin, en-bloc technique before a radical resection code holds up. The surgical narrative, not the tumor size alone, must match the billed descriptor.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The neck and anterior thorax family follows the same logic with different numbers. CPT 21556 covers subfascial tumors under 5 cm, and <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21554\/\">21554<\/a> covers 5 cm or greater. The upper arm and elbow pair splits the same way, with <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-24076\/\">24076<\/a> below 5 cm and 24073 at 5 cm or greater. Read any of these families as a grid of depth, size, and extent and most miscodes disappear.<\/p>\n\n\n\n<h2 id=\"h-modifiers-that-apply-to-23073\" class=\"wp-block-heading\">Modifiers that apply to 23073<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier selection for CPT code 23073 follows standard surgical coding rules governed by the National Correct Coding Initiative (NCCI). Using the wrong modifier, or omitting a required one, is one of the fastest routes to a rejected shoulder excision claim.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Name<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to use<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key consideration<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-LT \/ -RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left side \/ Right side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Always required, since laterality must be specified for shoulder procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Required by Medicare; omission triggers edit<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-50<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bilateral procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When the procedure is performed on both shoulders in the same session<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medicare pays 150% of the unilateral rate; some payers differ<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-51<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When 23073 is performed alongside another distinct surgical procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Apply to the secondary procedure; not applicable to exempt codes<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-59<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Distinct procedural service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When a second procedure on the same day requires unbundling from NCCI edits<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use only when clinically appropriate, since overuse invites an audit<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-22<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Increased procedural services<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Exceptional surgical complexity beyond typical 23073 effort<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Requires operative note narrative justifying the modifier; attach documentation<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-58<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Staged or related procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Planned subsequent procedure during the global period of a prior service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Resets the global period; use carefully<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Commercial payer modifier rules sometimes diverge from Medicare NCCI edits. Always check payer-specific policies before submitting, particularly for modifier -50 bilateral claims.<\/p>\n\n\n\n<h2 id=\"h-icd-10-diagnosis-codes-that-pair-with-23073\" class=\"wp-block-heading\">ICD-10 diagnosis codes that pair with 23073<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The ICD-10-CM diagnosis code paired with CPT code 23073 must establish medical necessity for the excision. Correct pairing is a common audit trigger. Coding a malignant histology against a benign post-operative pathology report creates the kind of inconsistency payers flag.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Laterality matters here as much as histology. The diagnosis code has to name the same side as the -LT or -RT modifier on the claim line.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Clinical context<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">D21.11<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Benign neoplasm of connective and other soft tissue of right upper limb, including shoulder<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Most common pre-op diagnosis for benign intramuscular lipoma, right side<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">D21.12<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Benign neoplasm of connective and other soft tissue of left upper limb, including shoulder<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left-side equivalent of D21.11<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">C49.11<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Malignant neoplasm of connective and soft tissue of right upper limb, including shoulder<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use when pre-operative biopsy or imaging strongly suggests soft tissue sarcoma<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">C49.12<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Malignant neoplasm of connective and soft tissue of left upper limb, including shoulder<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left-side equivalent of C49.11<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">D48.1<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Neoplasm of uncertain behavior of connective and other soft tissue<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When histologic behavior is not yet determined; often used pre-pathology<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M79.621<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Pain in right upper arm<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Secondary symptom code; use as additional diagnosis when pain drives the surgical indication<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Pathology sometimes changes the diagnosis after surgery, for example from uncertain behavior to confirmed malignancy. The claim then needs resubmission with the corrected ICD-10 code, and most payers accept corrections within 90 days of the original submission date.<\/p>\n\n\n\n<h2 id=\"h-medicare-reimbursement-and-the-fee-schedule\" class=\"wp-block-heading\">Medicare reimbursement and the fee schedule<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare reimbursement for CPT code 23073 varies by place of service and geographic locality. The <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule<\/a> publishes updated rates annually. Verify current-year figures through the CMS MPFS Look-Up Tool, since the conversion factor is adjusted every calendar year.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Dollar amounts move every year with the conversion factor and with Geographic Practice Cost Index adjustments. Use the <a href=\"https:\/\/fastrvu.com\/tools\/rvu-lookup\" target=\"_blank\" rel=\"nofollow noopener\">FastRVU 2026 RVU lookup tool<\/a> to calculate the current payment for your locality.<\/p>\n\n\n\n<h3 id=\"h-relative-value-units-rvus-for-cpt-23073\" class=\"wp-block-heading\">Relative value units (RVUs) for CPT 23073<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The RVU breakdown for CPT code 23073 reflects a major surgical procedure with significant intraoperative complexity. The work RVU captures physician effort. The practice expense RVU accounts for overhead at the place of service. The malpractice RVU covers liability weighting.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">RVU component<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">What it captures<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Work RVU (wRVU)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician time, skill, intensity<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Intraoperative effort for subfascial dissection and tumor removal<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Practice Expense RVU (PE RVU)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Overhead, supplies, equipment<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Differs between facility and non-facility settings<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Malpractice RVU (MP RVU)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Liability risk weighting<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Reflects surgical risk associated with shoulder excision<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Total RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Sum multiplied by the conversion factor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiply by CMS annual conversion factor for dollar payment<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Verify current RVU values using the CMS MPFS Look-Up Tool or FastRVU. Values update each January 1 and are adjusted by Geographic Practice Cost Indices (GPCIs) for your locality.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Run your RVU calculations using the CMS MPFS Look-Up Tool for the specific calendar year and locality before finalizing fee schedule negotiations with commercial payers. National averages can sit well above or below what a high-cost metropolitan locality actually pays.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h3 id=\"h-facility-vs-non-facility-reimbursement\" class=\"wp-block-heading\">Facility vs non-facility reimbursement<\/h3>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Setting<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Place of service<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Rate type<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Facility<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hospital outpatient, ASC (POS 19, 21, 22)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Facility rate (lower physician payment)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Facility separately bills technical component<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Non-facility<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Office (POS 11)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Non-facility rate (higher physician payment)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician absorbs practice expense<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Place of service changes the physician payment for the same procedure. A facility setting such as hospital outpatient or an ASC pays the physician less, because the facility bills the technical component separately. Office-based excision under POS 11 pays the higher non-facility rate, since the physician absorbs the practice expense.<\/p>\n\n\n\n<h2 id=\"h-the-90-day-global-period\" class=\"wp-block-heading\">The 90-day global period<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 23073 carries a 90-day global surgery period (code: 090). All routine post-operative care provided within 90 days of surgery is bundled into the procedure payment. It cannot be billed separately without a modifier that signals a distinct reason for the visit.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Global period:<\/strong> 090 days (major surgery designation)<\/li>\n\n\n\n<li><strong>Included services:<\/strong> Routine E\/M visits related to recovery, wound checks, suture removal, and post-op imaging review within 90 days<\/li>\n\n\n\n<li><strong>Not included in global:<\/strong> Treatment of unrelated conditions, complications requiring a return to the OR, or services documented as unrelated to the surgery<\/li>\n\n\n\n<li><strong>Modifier -24:<\/strong> Use for unrelated E\/M visits during the global period<\/li>\n\n\n\n<li><strong>Modifier -79:<\/strong> Use for an unrelated procedure during the global period<\/li>\n\n\n\n<li><strong>Modifier -78:<\/strong> Use for a return to the OR for a complication of the original procedure<\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-billing-and-coding-tips-that-prevent-denials\" class=\"wp-block-heading\">Billing and coding tips that prevent denials<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">These points address the <a href=\"https:\/\/pabau.com\/procedure-codes\/denial-codes-in-medical-billing\/\">denial codes<\/a> that come up most often on shoulder soft tissue tumor excision claims.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Measure at the specimen, not the imaging:<\/strong> Some payers require the 5 cm threshold to be confirmed at the time of excision. Document the intraoperative measurement, not just the pre-op MRI estimate<\/li>\n\n\n\n<li><strong>Do not upcode on specimen weight:<\/strong> Size thresholds for 23073 refer to greatest dimension, not weight or volume. Document a linear measurement in centimeters<\/li>\n\n\n\n<li><strong>Avoid bundling errors with arthroscopy codes:<\/strong> NCCI edits may bundle a same-session diagnostic shoulder arthroscopy with 23073. Check the edits first, and apply modifier -59 only when clinically appropriate<\/li>\n\n\n\n<li><strong>Pre-authorize for commercial payers:<\/strong> Many commercial payers require <a href=\"https:\/\/pabau.com\/blog\/prior-authorization-process\/\">prior authorization<\/a> for soft tissue tumor excisions. Confirm that the authorization names the specific CPT code and size designation<\/li>\n\n\n\n<li><strong>ICD-10 must match the pathology direction:<\/strong> Malignant codes such as C49.11 need stronger medical necessity support than benign codes such as D21.11. The record must support the diagnosis at the time of service<\/li>\n\n\n\n<li><strong>Global period compliance:<\/strong> Front desk staff should know that follow-up visits within 90 days are included in the global payment. Booking them as standard E\/M visits creates a billing error<\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-how-practice-management-software-supports-accurate-23073-billing\" class=\"wp-block-heading\">How practice management software supports accurate 23073 billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most CPT code 23073 billing errors trace back to the distance between where clinical documentation lives and where billing happens. When operative notes sit in one system and modifier selection happens in another, transcription errors compound at every handoff.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/blog\/practice-management-software\/\">Practice management software<\/a> like Pabau closes that distance. Its <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management<\/a> tools sit inside the EHR. A coder can attach the CPT code, its modifiers, and the paired ICD-10 code while writing the note, before the claim leaves the practice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That matters most for orthopedic, plastic surgery, and <a href=\"https:\/\/pabau.com\/industry\/sports-medicine-software\/\">sports medicine practices<\/a> billing surgical codes every week. A single missed modifier or an undocumented tumor measurement can produce a denial that takes weeks to resolve.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-23073\/automate-claims-through-healthcode.webp\" alt=\"Automate claims and billing with Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Billing in Pabau records the payer, the procedure, and the amount against the visit, which keeps a corrected claim traceable.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&#8217;s <a href=\"https:\/\/pabau.com\/industry\/plastic-surgery-emr\/\">plastic surgery EMR<\/a> is built for practices that perform surgical excisions, biopsies, and musculoskeletal procedures. Your team can record tumor size, depth, and laterality in the operative note and have those details flow straight into the claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The result is fewer manual data entry steps, fewer transcription errors, and a cleaner audit trail when payers request documentation. Pabau also offers <a href=\"https:\/\/pabau.com\/blog\/ehr-integration\/\">EHR integration<\/a> with existing billing systems, for practices that already run a separate revenue cycle tool.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Reduce claim denials for surgical procedure codes                <\/h3>\n\n                <p class=\"description\">\n                    Pabau lets orthopedic and surgical practices attach CPT codes, modifiers, and ICD-10 codes inside the platform they already document in. Your billing team stops moving data between systems by hand.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau practice management platform for surgical billing\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Accurate 23073 coding comes down to two lines in the operative note. One states the depth of the dissection, and the other gives the greatest dimension of the specimen. Write both at the time of surgery and the rest of the claim follows.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A note that says only &#8220;deep mass excised&#8221; leaves the coder guessing. A guess that lands on 23071 costs the practice the difference, so fix the note template once and the same denial stops coming back.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau keeps modifiers, ICD-10 pairing, and operative note detail on a single claim for musculoskeletal procedures.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding another shoulder procedure?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-23462\/\">CPT code 23462<\/a> covers reimbursement, RVUs, and modifiers for a shoulder repair claim.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing tendon work in the same limb?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-24340\/\">CPT code 24340<\/a> walks through tenodesis of the biceps tendon at the elbow.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Adding an injection at the same visit?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20550\/\">CPT code 20550<\/a> explains how tendon sheath injections are coded and billed.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Taking an open biopsy before the excision?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20250\/\">CPT code 20250<\/a> sets out the documentation an open biopsy claim needs.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need the diagnosis code for a shoulder injury?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s43121s\/\">ICD-10 code S43.121S<\/a> covers sequela coding after a right AC joint dislocation.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1787038757174\"><h3 class=\"schema-faq-question\">What does CPT code 23073 mean?<\/h3> <p class=\"schema-faq-answer\">CPT code 23073 is the billing code for excision of a subfascial soft tissue tumor of the shoulder area measuring 5 cm or greater. Subfascial includes intramuscular tumors. The code sits in the Shoulder subsection (23000-23929) of the Musculoskeletal System chapter (20100-29999), published by the American Medical Association.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787038757175\"><h3 class=\"schema-faq-question\">What is the difference between CPT 23073 and CPT 23076?<\/h3> <p class=\"schema-faq-answer\">23073 and 23076 both describe subfascial excision of a shoulder soft tissue tumor, and only the size separates them. 23076 applies below 5 cm, and 23073 applies at 5 cm or greater. Measure the greatest dimension, and record the intraoperative measurement in the operative note.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787038757176\"><h3 class=\"schema-faq-question\">What is the global period for CPT code 23073?<\/h3> <p class=\"schema-faq-answer\">CPT code 23073 carries a 90-day global surgery period (090). All routine post-operative care within 90 days of surgery is bundled into the procedure payment and cannot be billed separately. Exceptions include unrelated conditions (modifier -24), unrelated procedures (modifier -79), and complications requiring a return to the OR (modifier -78).<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787038757177\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT code 23073?<\/h3> <p class=\"schema-faq-answer\">The modifiers used most often with CPT code 23073 are -LT or -RT for laterality, which Medicare requires, and -50 for a bilateral procedure. Others include -51 for multiple procedures, -59 for a distinct procedural service, -22 for increased complexity, and -58 for a staged procedure.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787038757178\"><h3 class=\"schema-faq-question\">Which ICD-10 codes are used with CPT 23073?<\/h3> <p class=\"schema-faq-answer\">D21.11 and D21.12 cover a benign connective tissue neoplasm of the right or left upper limb, including the shoulder. C49.11 and C49.12 cover malignant soft tissue neoplasms on each side. D48.1 applies when histologic behavior is not yet determined. Always match the diagnosis to the clinical picture at the time of service.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787038757179\"><h3 class=\"schema-faq-question\">What is the Medicare reimbursement rate for CPT 23073?<\/h3> <p class=\"schema-faq-answer\">Medicare payment for CPT code 23073 varies by geographic locality and place of service. The CMS conversion factor and GPCI adjustments change annually. Verify exact amounts in the CMS Physician Fee Schedule Look-Up Tool for the current year and your MAC jurisdiction. Non-facility rates are higher than facility rates for this code.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787038757180\"><h3 class=\"schema-faq-question\">How is CPT 23073 different from CPT 23077 and CPT 23078?<\/h3> <p class=\"schema-faq-answer\">23073 is a standard excision, while 23077 and 23078 are radical resection codes covering wide-margin en-bloc removal for oncologic clearance. 23077 applies below 5 cm, and 23078 applies at 5 cm or greater. The radical resection counterpart of 23073 is therefore 23078, not 23077. Billing a resection code for a standard excision is upcoding.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1787038757181\"><h3 class=\"schema-faq-question\">Does CPT 23071 apply to subfascial shoulder tumors?<\/h3> <p class=\"schema-faq-answer\">No. 23071 covers excision of a subcutaneous soft tissue tumor of the shoulder area measuring 3 cm or greater, which is a different depth category. The subfascial codes are 23076 below 5 cm and 23073 at 5 cm or greater. Using 23071 for an intramuscular tumor is a depth error, not a size error.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>CPT code 23073 covers the surgical excision of a subfascial soft tissue tumor of the shoulder area. The specimen must measure 5 cm or greater in its greatest dimension. The American Medical Association (AMA) publishes the CPT code set. Code 23073 sits in the Shoulder subsection (23000-23929) of the Musculoskeletal System chapter (20100-29999), under Excision [&hellip;]<\/p>\n","protected":false},"author":82,"featured_media":183385,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"83","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546,1125],"tags":[1602,1604],"class_list":["post-183386","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","category-musculoskeletal-pain-management","tag-cpt-modifiers","tag-excision-codes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT code 23073: Shoulder tumor excision at 5 cm or greater<\/title>\n<meta name=\"description\" content=\"CPT code 23073 covers subfascial shoulder tumor excision of 5 cm or greater. Below 5 cm the code is 23076.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-23073\/\" \/>\n<meta property=\"og:locale\" content=\"nl_NL\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT code 23073: Shoulder tumor excision at 5 cm or greater\" \/>\n<meta property=\"og:description\" content=\"CPT code 23073 covers subfascial shoulder tumor excision of 5 cm or greater. Below 5 cm the code is 23076.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-23073\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-18T12:04:12+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-18T12:54:38+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-23073.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Maja Popovska\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"Geschreven door\" \/>\n\t<meta name=\"twitter:data1\" content=\"Maja Popovska\" \/>\n\t<meta name=\"twitter:label2\" content=\"Geschatte leestijd\" \/>\n\t<meta name=\"twitter:data2\" content=\"13 minuten\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-23073\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-23073\\\/\"},\"author\":{\"name\":\"Maja Popovska\",\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/#\\\/schema\\\/person\\\/b00aec1dd379f0ddcf6137d78e2a21db\"},\"headline\":\"CPT code 23073: Shoulder soft tissue tumor excision guide\",\"datePublished\":\"2026-08-18T12:04:12+00:00\",\"dateModified\":\"2026-08-18T12:54:38+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-23073\\\/\"},\"wordCount\":2663,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-23073\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-23073.webp\",\"keywords\":[\"Cpt Modifiers\",\"Excision Codes\"],\"articleSection\":[\"Billing Codes\",\"CPT Codes\",\"Musculoskeletal &amp; Pain Management\"],\"inLanguage\":\"nl-NL\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-23073\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-23073\\\/\",\"name\":\"CPT code 23073: Shoulder tumor excision at 5 cm or greater\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-23073\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-23073\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-23073.webp\",\"datePublished\":\"2026-08-18T12:04:12+00:00\",\"dateModified\":\"2026-08-18T12:54:38+00:00\",\"description\":\"CPT code 23073 covers subfascial shoulder tumor excision of 5 cm or greater. 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Billing a resection code for a standard excision is upcoding.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"},{"@type":"Question","@id":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-23073\/#faq-question-1787038757181","position":8,"url":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-23073\/#faq-question-1787038757181","name":"Does CPT 23071 apply to subfascial shoulder tumors?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. 23071 covers excision of a subcutaneous soft tissue tumor of the shoulder area measuring 3 cm or greater, which is a different depth category. The subfascial codes are 23076 below 5 cm and 23073 at 5 cm or greater. Using 23071 for an intramuscular tumor is a depth error, not a size error.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"}]}},"yoast":{"focus_keyword":"CPT code 23073","seo_title":"CPT code 23073: Shoulder tumor excision at 5 cm or greater","meta_description":"CPT code 23073 covers subfascial shoulder tumor excision of 5 cm or greater. Below 5 cm the code is 23076.","content_score":"30","is_cornerstone":"","related_keyphrases":[{"keyword":"shoulder excision CPT code","score":83},{"keyword":"subfascial tumor excision","score":83},{"keyword":"soft tissue tumor excision","score":93},{"keyword":"musculoskeletal CPT codes","score":72}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts\/183386","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/users\/82"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/comments?post=183386"}],"version-history":[{"count":4,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts\/183386\/revisions"}],"predecessor-version":[{"id":184161,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts\/183386\/revisions\/184161"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/media\/183385"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/media?parent=183386"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/categories?post=183386"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/tags?post=183386"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}