Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 23220 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.
Surgery For Tumor In Arm Bone, Surgery To Remove A Section Of Bone With An Abnormal Growth (Tumor) From The Arm Or Elbow. The Bone May Be Reconstructed With A Graft Or Prosthesis.
| 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 23220 |
| Medicaid Fee Schedule | View Medicaid rates for 23220 |
National average reimbursement for CPT 23220 by major payers:
$2,421.14
$2,377.40
$2,597.15
$2,973.93
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 23220.
CPT 23220
5 of 25 sample ratesHigher to lower in this preview
The Endoscopy Center At St. Francis, LLC
The Endoscopy Center At St Francis LLC
$17,511.00Published ratePrince Frederick Surgery Center LLC
Prince Frederick Surgery Center, LLC
$6,365.00Published rateSound Surgeons PLLC, Northwest Weight Loss Surgery
Sound Surgeons, PLLC
$3,482.00Published rateEvergreen Eye Center, PLLC, Eye Associates Northwest Surgery Center
Eye Associates Northwest, PLLC
$2,681.00Published rateWilliams Eye Institute, PC, Williams Eye Surgery Center
Williams Eye Institute
$682.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 23220 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23220 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 23220 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 |
|---|---|---|
| 23150-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From An Upper Arm Bone (Humerus). |
| 23156-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From An Upper Arm Bone (Humerus). The Procedure Uses A Bone Graft To Repair The Area. |
| 23184-CPT | High | Partial Excision (Craterizatio, Partial Excision (Craterization Saucerization Ordiaphysectomy) Bone (Eg Osteomyelitis) Proximal Humerus |
| 23220-CPT | High | Surgery For Tumor In Arm Bone, Surgery To Remove A Section Of Bone With An Abnormal Growth (Tumor) From The Arm Or Elbow. The Bone May Be Reconstructed With A Graft Or Prosthesis. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23220 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 23220) and we'll show you how you compare in 15 minutes or less.