CPT 23172 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 21 - Inpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 23172 by major payers:

$754.20

$758.90

$762.80

$957.11
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 23172 | ||||||
United | 23172 | $1673.00 | 1609465269 - OKLAHOMA SPINE SURGERY CENTER | 861507485 - (OK) OKLAHOMA SPINE SURGERY CENTER | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $6898.00 | 1740318153 - PLAZA SURGERY CENTER, L.P., PLAZA SURGERY CENTER | 770573567 - (CA) PLAZA SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $5513.00 | 1023071560 - MEDICAL PLAZA AMBULATORY SURGERY CENTER ASSOCIATES, L.P., MEDICAL CITY SURGERY CENTER/FORT WORTH | 621489404 - (TX) MEDICAL PLAZA AMBULATORY SURGERY CENTER ASSOCIATES LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $2855.00 | 1114549805 - BSC 1 LLC | 851036387 - (AZ) BSC 1 LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $1161.00 | 1437100666 - HEARTLAND CATARACT & LASER SURGERY CENTER, INC., HEARTLAND CATARACT & LASER SURGERY CENTER | 470824936 - (NE) HEARTLAND CATARACT LASER SURGERY CENTER INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $1255.00 | 1487090452 - DIGESTIVE HEALTH SPECIALISTS, PA | 561242980 - (NC) DIGESTIVE HEALTH SPECIALISTS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $3200.00 | 1316082365 - WEST WILSHIRE MEDICAL SURGICAL CENTER INC. | 954421811 - (CA) WEST WILSHIRE MEDICAL SURGICAL C | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $2175.00 | 1801994553 - BARRINGTON SURGICAL CARE LLC, BARRINGTON SURGICAL CARE | 203991455 - (NH) BARRINGTON SURGICAL CARE LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $5349.00 | 1497749436 - NEW JERSEY SURGERY CENTER LLC, NEW JERSEY SURGERY CENTER | 161666417 - (NJ) NEW JERSEY SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $1379.00 | 1346215316 - CHESAPEAKE EYE SURGERY CENTER, LLC | 522310068 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $4140.00 | 1073694550 - ROCKWALL AMBULATORY SURGERY CENTER LLP, BAYLOR SCOTT & WHITE SURGICARE - ROCKWALL | 205506447 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $2204.00 | 1730601865 - SNAPFINGER VASCULAR ACCESS CENTER ASC LLC | 821940644 - (GA) SNAPFINGER VASCULAR ACCESS CENTER ASC LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $2450.00 | 1306375837 - CENTRAL COAST CARDIOVASCULAR ASC LLC | 821736669 - (CA) CENTRAL COAST CARDIOVASCULAR ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $1307.00 | 1366529638 - NGC ENDOSCOPY SERVICES LLC | 931307280 - (OR) NGC ENDOSCOPY SERVICES LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23172 | $2363.00 | 1073713004 - ADVANCED EYE SURGERY CENTER | 205045500 - (CA) ADVANCED EYE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 23172 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23172 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 23172 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23172. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23172 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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