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CPT 23174 Fee Schedule

Last Verified: March 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.

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
Medicare Fee ScheduleView Medicare rates for 23174

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$1224.001265488563 - SYRACUSE ASC, LLC, SPECIALTY SURGERY CENTER OF CNY161549512 - (NY) SPECIALTY SURGERY CENTER OF CNYNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$3500.001811433410 - OPHTHALMOLOGY SURGERY CENTER OF ORLANDO LLC, ORLANDO OPHTHALMOLOGY SURGERY CENTER814378043FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$2717.001932164852 - MAY STREET SURGI CENTER, LLC, MAY STREET SURGI CENTER223777533 - (NJ) MAY STREET SURGI CENTER, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$1275.001740251909 - NORTH FLORIDA GI CENTER LTD, HCA FLORIDA NORTH FLORIDA ENDOSCOPY CENTER621727350 - (FL) NORTH FLORIDA GI CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$4781.001457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER364533553 - (NJ) HUDSON CROSSING SURGICAL CENTERNJAmbulatory 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$1823.001932438553 - MIDDLESEX CENTER FOR ADVANCED ORTHOPEDIC SURGERY263528303 - (CT) MIDDLESEX CENTER FOR ADVANCED ORTHOPEDIC SURGERYCTAmbulatory 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$3014.001962059915 - BRIGHTSIDE SURGICAL, LLC831888619 - (ND) BRIGHTSIDE SURGICAL LLCNDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$2376.001255796017 - GOSHEN HEALTH SURGERY CENTER, LLC475619052 - (IN) GOSHEN HEALTH SURGERY CENTER LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$3623.001558794081 - SURGERY CENTER OF SCOTTSDALE, LLC731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$1571.001912480070 - SOG SURGERY CENTER LLC822479805 - (MS) SOG SURGERY CENTER LLCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$1167.021750358453 - CENTER FOR DIGESTIVE HEALTH LTD391738062 - (WI) THE CENTER FOR DIGESTIVE HEALTH LTDWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$3455.001215978945 - SAPLING GROVE AMBULATORY SURGERY CENTER, LLC204450153 - (TN) SAPLING GROVE AMBULATORY SURGERY CENTER LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
23174$3095.001528104080 - SURGICAL CENTER AT CEDAR KNOLLS LLC202158771 - (NJ) SURGICAL CENTER AT CEDAR KNOLLSNJAmbulatory 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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