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See a sample rate comparisonCPT 23190 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.
Ostectomy Scapula Partial
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23190 |
| Medicaid Fee Schedule | View Medicaid rates for 23190 |
National average reimbursement for CPT 23190 by major payers:
$773.13
$767.51
$772.96
$943.49
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CPT 23190
5 of 25 sample ratesHigher to lower in this preview
Wisconsin Surgery Center LLC
Wisconsin Surgery Center, LLC
$9,270.00Published rateSurgcenter At Paradise Valley, LLC, Surgcenter At Pima Crossing
Surgcenter At Paradise Valley
$3,570.00Published rateK S Management Services LLC, Kelsey-Seybold Asc
$1,672.00Published rateValdosta Foot & Ankle Surgery Center, P.C.
Valdosta Foot Ankle Surgery Center PC
$1,383.00Published rateDigestive Health Center LLC
Digestive Health Center, Ltd.
$648.00Published rate
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See a sample payer proposalCPT 23190 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23190 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 23190 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 |
|---|---|---|
| 23182-CPT | Moderate | Partial Xcision (Craterizat Saucerizati Or Diaphysectomy) Bone, Partial Excision (Craterization Saucerization Or Diaphysectomy) Bone |
| 23190-CPT | Moderate | Ostectomy Scapula Partial |
| 23195-CPT | High | Resection Humeral Head |
| 23210-CPT | High | Remove Bone With Tumor, Surgery To Remove An Abnormal Growth (Tumor) Including Part Of The Shoulder Blade (Scapula) And Surrounding Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23190. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23190 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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