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CPT 23220 Fee Schedule

Last Verified: January 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.

Extensive Removal Of Growth Of Upper End Of Upper Arm
Key FactDetail
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 LevelHigh
Medicare Fee ScheduleView Medicare rates for 23220

National average reimbursement for CPT 23220 by major payers:

bcbs

$2,421.14

uhc

$2,377.40

aetna

$2,597.15

cigna

$3,043.71

Preview provider-level rates for...
For billing codeCPT 23220
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 23220

United
23220$2363.001659625101 - ENDOSCOPY CENTER OF GRAND JUNCTION LLC461251610COAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$5851.001326094491 - PROLIANCE SURGEONS INC PS, PROLIANCE CENTER FOR SPECIALTY SURGERY911606533 - (WA) PROLIANCE SURGEONS, INC., P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$837.001518155811 - THE ALTAMONTE SPRINGS FL ENDOSCOPY ASC LLC, PALM ENDOSCOPY CENTER260289067FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$6588.001174802045 - LEONARDTOWN SURGERY CENTER LLC452019132 - (MD) LEONARDTOWN SURGERY CENTER, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$3482.001396123865 - SOUND SURGEONS PLLC, NORTHWEST WEIGHT LOSS SURGERY461190829 - (WA) SOUND SURGEONS, PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$682.001689670390 - WILLIAMS EYE INSTITUTE, PC, WILLIAMS EYE SURGERY CENTER351401963 - (IN) WILLIAMS EYE INSTITUTEINAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$3560.001396214938 - GRACE SURGERY CENTER LLC830543417 - (FL) GRACE SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$17511.001578561890 - THE ENDOSCOPY CENTER AT ST. FRANCIS, LLC351958962 - (IN) THE ENDOSCOPY CENTER AT ST FRANCIS LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$2410.001215185335 - ASC DEVELOPMENT COMPANY, LLC203405773 - (MD) ASC DEVELOPMENT COMPANY LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$3100.001134363690 - OAM SURGERY CENTER AT MIDTOWNE, LLC, METRO HEALTH OAM SURGERY CENTER261805066 - (MI) OAM SURGERY CENTER AT MIDTOWNE LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$3391.001023199601 - ANNE ARUNDEL UROLOGICAL SURGERY CENTER LLC522012685MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$6492.001275292229 - SCOTTSDALE ENDOSCOPY ASC LLC873952617AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$1800.001023123296 - ASSOCIATES SURGERY CENTERS, LLC510492139 - (PA) ASSOCIATES SURGERY CENTERS LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$2223.001851312771 - COLUMBUS ENDOSCOPY CENTER, INC640926861 - (MS) COLUMBUS ENDOSCOPY CENTER INCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
23220$2737.001558327213 - SURGICARE OF JACKSON LTD752162993 - (MS) SURGICARE OF JACKSON LTDMSAmbulatory 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 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.

CodeComplexityDescription
23150-CPTModerateExc Lesion Proximal Humerus
23156-CPTModerateExc Lesion Prox Humerus W Homog
23184-CPTHighExc Proximal Humerus Partial
23220-CPTHighExtensive Removal Of Growth Of Upper End Of Upper Arm

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.

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