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See a sample rate comparisonCPT 23210 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Remove Bone With Tumor, Surgery To Remove An Abnormal Growth (Tumor) Including Part Of The Shoulder Blade (Scapula) And Surrounding Tissue.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 23210 |
| Medicaid Fee Schedule | View Medicaid rates for 23210 |
National average reimbursement for CPT 23210 by major payers:
$1,954.94
$2,145.00
$2,345.41
$2,700.95
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CPT 23210
5 of 25 sample ratesHigher to lower in this preview
Summit Orthopedic Surgery Center, LLC, Sosc
Summit Orthopedic Surgery Center LLC
$14,322.00Published rateDestin Surgery Center LLC
$6,087.00Published rateBone And Joint Surgical Suites, LLC
Bone And Joint Surgical Suites LLC
$3,772.00Published rateGreenville Endoscopy Center Inc
$2,208.00Published rateMesquite Surgery Center LLC
Mesquite Surgery Center, LLC
$863.00Published rate
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See a sample payer proposalCPT 23210 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23210 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 23210 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 |
|---|---|---|
| 23125-CPT | Moderate | Claviculectomy; Total |
| 23182-CPT | Moderate | Partial Xcision (Craterizat Saucerizati Or Diaphysectomy) Bone, Partial Excision (Craterization Saucerization Or Diaphysectomy) Bone |
| 23190-CPT | Moderate | Ostectomy Scapula Partial |
| 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 23210. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23210 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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