Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 23125 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.
Claviculectomy; Total
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 24 - Ambulatory Surgical Center 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 23125 |
| Medicaid Fee Schedule | View Medicaid rates for 23125 |
National average reimbursement for CPT 23125 by major payers:
$905.43
$957.18
$968.71
$1,168.34
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 23125.
CPT 23125
5 of 25 sample ratesHigher to lower in this preview
Emory Ambulatory Surgery Center At Dunwoody, LLC
Emory Ambulatory Surgery Center At Dunwoody LLC
$5,900.00Published rateGcsa Ambulatory Surgery Center, LLC
Gcsa Ambulatory Surgery Center LLC
$3,570.00Published rateSan Joaquin Laser Surgery Center
$2,058.00Published rateAdvanced Eye Medical Group A Professional Corporation, Ophthalmology Medical Center
Advanced Eye Medical Group A Professional Corporation
$1,484.00Published rateBattle Creek Endoscopy & Surgery LLC
Battle Creek Endoscopy & Surgery Center PLLC
$869.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 23125 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23125 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 23125 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 |
|---|---|---|
| 23120-CPT | Moderate | Claviculectomy Partial |
| 23125-CPT | Moderate | Claviculectomy; Total |
| 23180-CPT | Moderate | Partial Xcision (Craterizat Saucerizati Or Diaphysectomy) Bone, Partial Excision (Craterization Saucerization Or Diaphysectomy) Bone |
| 23184-CPT | High | Partial Excision (Craterizatio, Partial Excision (Craterization Saucerization Ordiaphysectomy) Bone (Eg Osteomyelitis) Proximal Humerus |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23125. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23125 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 23125) and we'll show you how you compare in 15 minutes or less.