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See a sample rate comparisonCPT 23030 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.
Drain Shoulder Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Shoulder.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23030 |
| Medicaid Fee Schedule | View Medicaid rates for 23030 |
National average reimbursement for CPT 23030 by major payers:
$523.80
$572.21
$615.26
$432.56
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CPT 23030
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Kingsland LLC, Memorial Hermann Surgery Center Kingsland
$5,729.00Published rateSequoia Surgery Center, LLC, Cypress Surgery Center, A Limited Partnership
Sequoia Surgery Center, LLC
$1,913.00Published rateShadyside Surgi-Center, Inc.
Shadyside Surgicenter Inc
$1,100.00Published rateSouth Hills Diagnostic & Treatment Center Lp, South Hills Endoscopy Center
South Hills Diagnostic Treatment Center Lp
$825.00Published rateArizona Surgical Arts, Inc.
Arizona Surgical Arts Inc
$507.00Published rate
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See a sample payer proposalCPT 23030 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23030 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 23030 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 23030. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23030 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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