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See a sample rate comparisonCPT 23395 Fee Schedule
Last Verified: September 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.
Transfer Muscle Shoulder Single
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 23395 |
| Medicaid Fee Schedule | View Medicaid rates for 23395 |
National average reimbursement for CPT 23395 by major payers:
$1,757.74
$1,727.83
$1,804.45
$2,090.00
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CPT 23395
5 of 25 sample ratesHigher to lower in this preview
Marin Health Ventures, LLC, Marin Specialty Surgery Center
Marin Health Ventures, Inc. Dba Marin Specialty Surgery Center
$7,827.00Published rateLake Ridge Ambulatory Surgery Center, LLC, Lake Ridge Surgery Center
Lake Ridge Ambulatory Surgery Center LLC
$4,244.00Published rateAdvanced Surgery Center Of Lancaster, LLC
Advanced Surgery Center Of Lancaster LLC
$2,927.00Published rateSurgery Center Of Columbia County, LLC, Surgery Center Of Columbia County
Surgery Center Of Columbia Cty
$1,850.00Published rateKeystone Kidney Associates, PC
Keystone Kidney Associates PC
$600.00Published rate
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See a sample payer proposalCPT 23395 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23395 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 23395 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 |
|---|---|---|
| 23395-CPT | High | Transfer Muscle Shoulder Single |
| 23397-CPT | High | Musc Txfr,Shldr/Arm Paralysis;Multi |
| 23400-CPT | High | Reposition Shoulder Blade, Surgery To Reposition The Shoulder Blade (Scapula) And Reorient The Associated Muscles And Tendons. |
| 23405-CPT | Moderate | Tenomyotomy, Shoulder Area; Single |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23395. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23395 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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