23035 Incision bone cortex sho
What 23035 is
CMS fee schedule short descriptor: Incision bone cortex sho.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 23035 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 8.93 | 8.23 | 1.84 | 19.00 | $634.62 |
| Facility (hospital, ASC) | 8.93 | 8.23 | 1.84 | 19.00 | $634.62 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.
Medically Unlikely Edit (MUE)
Medicare caps 23035 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 23035? These codes are bundled into it
23035 is a Column 1 code in 236 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
01610 | Anes all px nrv musc sho&ax | 0 - no modifier bypass | Check pair |
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0707T | Njx b1 sub mtrl sbchdrl dfct | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
0869T | Njx b1 sub mtrl hw fixj aug | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
10030 | Img gid flu coll drg sft tis | 1 - modifier may bypass | Check pair |
10060 | I&d abscess simple/single | 1 - modifier may bypass | Check pair |
10140 | I&d hmtma seroma/fluid collj | 1 - modifier may bypass | Check pair |
10160 | Pnxr aspir absc hmtma bulla | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
12013 | Rpr f/e/e/n/l/m 2.6-5.0 cm | 1 - modifier may bypass | Check pair |
12014 | Rpr f/e/e/n/l/m 5.1-7.5 cm | 1 - modifier may bypass | Check pair |
12015 | Rpr f/e/e/n/l/m 7.6-12.5 cm | 1 - modifier may bypass | Check pair |
12016 | Rpr fe/e/en/l/m 12.6-20.0 cm | 1 - modifier may bypass | Check pair |
12017 | Rpr fe/e/en/l/m 20.1-30.0 cm | 1 - modifier may bypass | Check pair |
12018 | Rpr f/e/e/n/l/m >30.0 cm | 1 - modifier may bypass | Check pair |
Showing 30 of 236 column 2 codes. Use the pair checker for any specific combination.
23035 is bundled into these codes
23035 appears as a Column 2 code in 16 active edits. Reported with one of these Column 1 codes on the same date of service, 23035 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
11010 | Debride skin at fx site | 1 | Check pair |
11011 | Debride skin musc at fx site | 1 | Check pair |
11012 | Deb skin bone at fx site | 1 | Check pair |
23030 | I&d shoulder deep absc/hmtma | 1 | Check pair |
23031 | I&d shoulder infected bursa | 1 | Check pair |
23040 | Arthrt gh jt expl/drg/rmv fb | 1 | Check pair |
23044 | Arthrt ac sc jt exp/rmvl fb | 1 | Check pair |
23170 | Sequestrectomy clavicle | 1 | Check pair |
23172 | Sequestrectomy scapula | 1 | Check pair |
23174 | Sqstrctmy humrl head srg nck | 1 | Check pair |
23180 | Prtl excision bone clavicle | 1 | Check pair |
23182 | Prtl excision bone scapula | 1 | Check pair |
23184 | Prtl excision bone prox hum | 1 | Check pair |
23200 | Radical rescj tumor clavicle | 1 | Check pair |
23210 | Radical rescj tumor scapula | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.