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See a sample rate comparisonCPT 23035 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.
Ncision Bone Cortex (Eg Osteomyeli Or Bone Absces) Shlder, Incision Bone Cortex (Eg Osteomyelitis Or Bone Abscess) Shoulder Ar
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23035 |
| Medicaid Fee Schedule | View Medicaid rates for 23035 |
National average reimbursement for CPT 23035 by major payers:
$959.84
$926.19
$937.32
$1,126.57
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CPT 23035
5 of 25 sample ratesHigher to lower in this preview
Physicians West Houston Surgical Center, LLC, Memorial Hermann Surgery Center Park Ten
$5,048.00Published rateTenn Sm LLC
$2,388.00Published ratePleasant View Surgery Center, LLC
$1,525.00Published rateCapital Surgery Center LLC
$1,044.00Published rateKristi Cottrell
Deaconess Hospital Inc
$541.69Published rate
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See a sample payer proposalCPT 23035 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23035 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 23035 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 |
|---|---|---|
| 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. |
| 23035-CPT | Moderate | Ncision Bone Cortex (Eg Osteomyeli Or Bone Absces) Shlder, Incision Bone Cortex (Eg Osteomyelitis Or Bone Abscess) Shoulder Ar |
| 23040-CPT | Moderate | Arthrotomy Glenohumeral Joint, Arthrotomy Glenohumeral Joint Including Explorationdrainage Or Removal Of Foreign Body Arthrotomy Glenohumeral Joint Including Exploration |
| 23100-CPT | Moderate | Shoulder Surgery With Biopsy, Exploratory Surgery Of A Shoulder Joint. The Procedure Includes Removal Of A Sample Of Tissue For Testing (Biopsy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23035 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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