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CPT 23174 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 Humerus Neck
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

21 - Inpatient Hospital

11 - Office

Common Modifiers

None

RT - Right side of body

51 - Multiple procedures

Complexity LevelModerate

National average reimbursement for CPT 23174 by major payers:

bcbs

$946.62

uhc

$1,022.83

aetna

$1,033.98

cigna

$1,283.76

Preview provider-level rates for...
For billing codeCPT 23174
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 23174

United
23174$724.001518998764 - TENNESSEE PAIN SURGERY CENTER, LLC621790133 - (TN) TENNESSEE PAIN SURGERY CENTER LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$3500.001811433410 - OPHTHALMOLOGY SURGERY CENTER OF ORLANDO LLC, ORLANDO OPHTHALMOLOGY SURGERY CENTER814378043FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$1980.001760465207 - PLASTIC SURGICAL CENTER OF RAPID CITY, PROF. L.L.C.460441899 - (SD) PLASTIC SURGICAL CENTER OF RAPID CITY PROF LLCSDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$1801.001699751289 - EASTLAND MEDICAL PLAZA SURGICENTER, LLC371400643 - (IL) EASTLAND MEDICAL PLAZA SURGICENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$1410.001497727093 - BARNET DULANEY PERKINS EYE CENTER, PC, AMERICAN VISION PARTNERS562589722 - BARNET DULANEY PERKINS EYE CENTER PLLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$730.001093760019 - OCEAN COUNTY EYE ASSOCIATES LLC, OCEAN COUNTY EYE SURGERY CENTER223256927 - (NJ) OCEAN COUNTY EYE ASSOCIATES, P.C.NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$623.001992700090 - TAMPA BAY SPECIALTY SURGERY CENTER LLC, TAMPA BAY SPECIALTY SURGERY CENTER331019420 - (FL) TAMPA BAY SPECIALTY SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$1529.001386618783 - LEWES DE ENDOSCOPY ASC LLC, SEASIDE ENDOSCOPY PAVILION562299727 - (DE) LEWES DE ENDOSCOPY ASC LLCDEAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$5453.001730834730 - HERITAGE DEVELOPMENT PARTNERS, LLC, ORTHOPAEDIC SURGERY CENTER882720151 - (KY) HERITAGE DEVELOPMENT PARTNERS LLCKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$2795.001992713010 - NORTHFIELD SURGICAL CENTER LLC, NORTHFIELD SURGICAL CENTER223509801 - (NJ) NORTHFIELD SURGICAL CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$2325.001710127774 - NORTHERN CALIFORNIA ADVANCED SURGERY CENTER LP264264927 - (CA) NORTHERN CALIFORNIA ADVANCED SURGERY CENTER, LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$2637.001447949706 - BAPTIST HEALTH SURGERY CENTER, LLC, BAPTIST HEALTH SURGERY CENTER AT BOCA RATON RESEARCH PARK650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$1750.001871960153 - TURNER SURGERY CENTER, LLC, TURNER SURGERY CENTER611760062 - (TN) TURNER SURGERY CENTER LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$2100.001295119584 - WICHITA ASC LP, EPIC SURGERY CENTER471823557KSAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$3570.001003004482 - SUMMIT AMBULATORY SURGICAL CENTER, LLC522148280MDAmbulatory 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 23174 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 23174 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 23174 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
23170-CPTModerateSequestrectomy, Clavicle
23172-CPTModerateSequestrectomy Scapula
23174-CPTModerateSequestrectomy Humerus Neck
23180-CPTModerateExc Clavicle Partial

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23174. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 23174 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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