Data Platform
Sign InTry for Free

CPT 23172 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.

Sequestrectomy Scapula
Key FactDetail
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 LevelModerate

National average reimbursement for CPT 23172 by major payers:

bcbs

$754.20

uhc

$758.90

aetna

$762.80

cigna

$957.11

Preview provider-level rates for...
For billing codeCPT 23172
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 23172

United
23172$1673.001609465269 - OKLAHOMA SPINE SURGERY CENTER861507485 - (OK) OKLAHOMA SPINE SURGERY CENTEROKAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$6898.001740318153 - PLAZA SURGERY CENTER, L.P., PLAZA SURGERY CENTER770573567 - (CA) PLAZA SURGERY CENTER LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$5513.001023071560 - MEDICAL PLAZA AMBULATORY SURGERY CENTER ASSOCIATES, L.P., MEDICAL CITY SURGERY CENTER/FORT WORTH621489404 - (TX) MEDICAL PLAZA AMBULATORY SURGERY CENTER ASSOCIATES LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$2855.001114549805 - BSC 1 LLC851036387 - (AZ) BSC 1 LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$1161.001437100666 - HEARTLAND CATARACT & LASER SURGERY CENTER, INC., HEARTLAND CATARACT & LASER SURGERY CENTER470824936 - (NE) HEARTLAND CATARACT LASER SURGERY CENTER INCNEAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$1255.001487090452 - DIGESTIVE HEALTH SPECIALISTS, PA561242980 - (NC) DIGESTIVE HEALTH SPECIALISTS, P.A.NCAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$3200.001316082365 - WEST WILSHIRE MEDICAL SURGICAL CENTER INC.954421811 - (CA) WEST WILSHIRE MEDICAL SURGICAL CCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$2175.001801994553 - BARRINGTON SURGICAL CARE LLC, BARRINGTON SURGICAL CARE203991455 - (NH) BARRINGTON SURGICAL CARE LLCNHAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$5349.001497749436 - NEW JERSEY SURGERY CENTER LLC, NEW JERSEY SURGERY CENTER161666417 - (NJ) NEW JERSEY SURGERY CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$1379.001346215316 - CHESAPEAKE EYE SURGERY CENTER, LLC522310068MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$4140.001073694550 - ROCKWALL AMBULATORY SURGERY CENTER LLP, BAYLOR SCOTT & WHITE SURGICARE - ROCKWALL205506447TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$2204.001730601865 - SNAPFINGER VASCULAR ACCESS CENTER ASC LLC821940644 - (GA) SNAPFINGER VASCULAR ACCESS CENTER ASC LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$2450.001306375837 - CENTRAL COAST CARDIOVASCULAR ASC LLC821736669 - (CA) CENTRAL COAST CARDIOVASCULAR ASC LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$1307.001366529638 - NGC ENDOSCOPY SERVICES LLC931307280 - (OR) NGC ENDOSCOPY SERVICES LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
23172$2363.001073713004 - ADVANCED EYE SURGERY CENTER205045500 - (CA) ADVANCED EYE SURGERY CENTERCAAmbulatory 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

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

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.

CodeComplexityDescription
23120-CPTModerateClaviculectomy Partial
23170-CPTModerateSequestrectomy, Clavicle
23172-CPTModerateSequestrectomy Scapula
23174-CPTModerateSequestrectomy Humerus Neck

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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 23172) and we'll show you how you compare in 15 minutes or less.