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See a sample rate comparisonCPT 23020 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Release Of Contracted Muscle, Surgical Procedure To Release Scar Tissue (Shortening And Hardening Of Tissue) That Forms Around The Site Of A Breast Implant.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | 59 - Distinct Procedural Service RT - Right side of body None |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23020 |
| Medicaid Fee Schedule | View Medicaid rates for 23020 |
National average reimbursement for CPT 23020 by major payers:
$877.78
$931.97
$937.75
$1,135.93
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CPT 23020
5 of 25 sample ratesHigher to lower in this preview
Coast Surgery Center L P, Coast Surgery Center Of South Bay
Coast Surgery Center L P
$4,339.00Published rateBanner Surgery Center
$2,799.00Published rateAsc Development Company, LLC
Asc Development Company LLC
$1,763.00Published rateTotal Pain Care LLC
Total Pain Care, LLC
$1,222.00Published rateVision Institute Of Michigan Surgery Center PC, Surgery Center Of Michigan
$643.00Published rate
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See a sample payer proposalCPT 23020 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23020 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 23020 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 23000-CPT | Moderate | Remove Subdeltoid Calcium Deposit |
| 23020-CPT | Moderate | Release Of Contracted Muscle, Surgical Procedure To Release Scar Tissue (Shortening And Hardening Of Tissue) That Forms Around The Site Of A Breast Implant. |
| 23030-CPT | Moderate | Drain Shoulder Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Shoulder. |
| 23031-CPT | Moderate | Drain Shoulder Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Shoulder. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23020 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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