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See a sample rate comparisonCPT 23105 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.
Shoulder Joint Surgery, Surgery To Remove Tissue From Inside A Shoulder Joint. The Procedure May Include Removing A Sample Of Tissue For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service RT - Right side of body None |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23105 |
| Medicaid Fee Schedule | View Medicaid rates for 23105 |
National average reimbursement for CPT 23105 by major payers:
$832.43
$862.50
$886.23
$1,057.30
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CPT 23105
5 of 25 sample ratesHigher to lower in this preview
Central Austin Ambulatory Surgery Center L.P., Dba Central Park Surgery Center
$4,633.00Published rateBcc Chandler LLC
$2,855.00Published ratePlanned Parenthood Of Greater Texas Surgical Health Services
$2,010.00Published rateCataract And Laser Center Of The North Shore, LLC
Cataract And Laser Center Of The North Shore LLC
$1,634.00Published rateMetropolitan Medical Center, LLC
Metropolitan Medical Center LLC
$915.00Published rate
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See a sample payer proposalCPT 23105 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23105 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 23105 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 |
| 23105-CPT | Moderate | Shoulder Joint Surgery, Surgery To Remove Tissue From Inside A Shoulder Joint. The Procedure May Include Removing A Sample Of Tissue For Testing (Biopsy). |
| 23106-CPT | Moderate | Collarbone Joint Surgery, Surgery To Remove Tissue From Inside The Joint Between The Collarbone And Breastbone. The Procedure May Include Removing 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 23105. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23105 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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