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CPT 23065 Fee Schedule

Last Verified: December 2025

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.

Biopsy,Soft Tissue Of Shoulder Area; Sup
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

11 - Office

None

Common Modifiers

None

51 - Multiple procedures

LT - Left side of body

Complexity LevelModerate

National average reimbursement for CPT 23065 by major payers:

bcbs

$294.05

uhc

$288.33

aetna

$295.71

cigna

$368.98

Preview provider-level rates for...
For billing codeCPT 23065
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 23065

United
23065$487.001245988955 - PALM BEACH REGIONAL OPCO LLC874629018 - (FL) PALM BEACH REGIONAL OPCO LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$700.001831368356 - VERMONT EYE SURGERY & LASER CENTER204872230 - (VT) VERMONT EYE SURGERY & LASER CENTER, LLC 401(K) PLANVTAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$551.001508840893 - PARKWAY SURGERY CENTER621799370 - (SC) PARKWAY SURGERY CENTER, LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$375.001710985445 - HERSHEY ENDOSCOPY CENTER, LLC562336622 - (PA) HERSHEY ENDOSCOPY CENTER, LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$387.921700855244 - THOMAS GREEN350593390 - DEACONESS HOSPITAL INCNCInternal Medicine Physician (207R00000X)
United
23065$387.921255473625 - HILARY NWOSU350593390 - DEACONESS HOSPITAL INCCAEmergency Medicine Physician (207P00000X)
United
23065$235.001760658256 - HARVARD SURGERY CENTER LLC208147301LAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$1392.001558328096 - NEWPORT BEACH ENDOSCOPY CENTER, LLC770368744 - (CA) NEWPORT BEACH ENDOSCOPY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$887.001073944039 - THE POLYCLINIC, THE POLYCLINIC PLASTIC SURGERY CENTER910369070 - (WA) THE POLYCLINIC, PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$240.001710952130 - MARYLAND ENDOSCOPY CENTER LLC, MARYLAND ENDOSCOPY CENTER521888989 - (MD) MARYLAND ENDOSCOPY CENTER, LLC.MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$736.001558456459 - PORTLAND ENDOSCOPY CENTER10432678 - (ME) PORTLAND ENDOSCOPY CENTERMEAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$500.001487625802 - PERIMETER CENTER FOR OUTPATIENT SURGERY LP581978405 - (GA) PERIMETER CENTER FOR OUTPATIENT SURGERY LPGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$750.001053835983 - GROUP SURGICAL PARTNERS INTEGRATED LLC, LEGENT OUTPATIENT SURGERY - FRISCO821249116 - (TX) GROUP SURGICAL PARTNERS INTEGRATED LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$507.001710952841 - ANDOCHICK SURGICAL CENTER LLC, PHYSICIANS SURGERY CENTER OF FREDERICK522239166 - (MD) ANDOCHICK SURGICAL CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23065$272.001841578978 - PHYSICIANS' SURGERY CENTER OF NEVADA LLC273741243 - (NV) PHYSICIANS SURGERY CENTER OF NEVADA LLCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 23065 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 23065 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 23065 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.

CodeComplexityDescription
23065-CPTModerateBiopsy,Soft Tissue Of Shoulder Area; Sup
23066-CPTModerateBiopsy Soft Tissue Shoulder Deep
23071-CPTModerateExcision Tumor Soft Tissue Shoulder Subq 3 Cm
23073-CPTModerateExc Tumor Soft Tissue Shoulder Subfascial 5 Cm

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 23065 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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