23101 Arthrt acrmclv/strnclav jt
What 23101 is
CMS fee schedule short descriptor: Arthrt acrmclv/strnclav jt.
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 23101 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 5.58 | 6.50 | 1.20 | 13.28 | $443.56 |
| Facility (hospital, ASC) | 5.58 | 6.50 | 1.20 | 13.28 | $443.56 |
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 23101 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 23101? These codes are bundled into it
23101 is a Column 1 code in 260 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 |
0566T | Autol cell implt adps njx | 1 - modifier may 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 |
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 |
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 |
10005 | Fna bx w/us gdn 1st les | 1 - modifier may bypass | Check pair |
10007 | Fna bx w/fluor gdn 1st les | 1 - modifier may bypass | Check pair |
10009 | Fna bx w/ct gdn 1st les | 1 - modifier may bypass | Check pair |
10011 | Fna bx w/mr gdn 1st les | 1 - modifier may bypass | Check pair |
10021 | Fna bx w/o img gdn 1st les | 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 |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11001 | Dbrdmt ecz/infct skn ea addl | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 1 - modifier may bypass | Check pair |
11012 | Deb skin bone at fx site | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
11045 | Dbrdmt subq tiss each addl | 1 - modifier may bypass | Check pair |
Showing 30 of 260 column 2 codes. Use the pair checker for any specific combination.
23101 is bundled into these codes
23101 appears as a Column 2 code in 12 active edits. Reported with one of these Column 1 codes on the same date of service, 23101 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 |
23044 | Arthrt ac sc jt exp/rmvl fb | 1 | Check pair |
23106 | Arthrotomy strnclav joint | 1 | Check pair |
23120 | Claviculectomy partial | 1 | Check pair |
23125 | Claviculectomy total | 1 | Check pair |
23180 | Prtl excision bone clavicle | 1 | Check pair |
23200 | Radical rescj tumor clavicle | 1 | Check pair |
23530 | Optx strnclav dislc aqt/chrn | 1 | Check pair |
23532 | Optx strclv dslc aq/chrn grf | 1 | Check pair |
23550 | Optx acromclv dislc aqt/chrn | 1 | Check pair |
23552 | Optx acrclv dslc aq/chrn grf | 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.