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CPT 23397 Fee Schedule

Last Verified: December 2025

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.

Musc Txfr,Shldr/Arm Paralysis;Multi
Key FactDetail
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 LevelHigh

National average reimbursement for CPT 23397 by major payers:

bcbs

$1,598.85

uhc

$1,546.52

aetna

$1,556.22

cigna

$1,911.03

Preview provider-level rates for...
For billing codeCPT 23397
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 23397

United
23397$5503.001124084843 - ST CLOUD OUTPATIENT SURGERY LTD752201400MNAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$5249.001144331760 - RESURGENS SURGERY CENTER LLC582397841 - (GA) RESURGENS SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$790.001598189342 - MEI SURGERY CENTER LLC, MICHIGAN EYE SURGERY CENTER461591012 - (MI) MEI SURGERY CENTER LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$1203.001538110713 - CENTER FOR DIGESTIVE HEALTH LLC201606438 - (MS) CENTER FOR DIGESTIVE HEALTH LLCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$10317.001003897448 - NORTHWEST SURGERY CENTER LLC, FOOT & ANKLE SURGERY CENTER208754071INAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$1150.001083228365 - REFOCUS SURGERY CENTERS, LLC851258648CTAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$1787.001457379364 - JONESBORO SURGERY CENTER, LLC731589472ARAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$1600.001740230523 - SARASOTA AMBULATORY SURGERY CENTER LTD, SARASOTA AMBULATORY SURGERY CENTER203686491 - (FL) SARASOTA AMBULATORY SURGERY CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$2600.001649393695 - COLUMBIA MD ORTHOPAEDIC ASC, LLC, HICKORY RIDGE SURGERY CENTER522377233 - (MD) COLUMBIA MD ORTHOPAEDIC ASC LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$4234.001275536328 - BELLAIRE OUTPATIENT SURGERY CENTER, LLP, BAYLOR SCOTT & WHITE SURGICARE - OAKMONT562297308 - (TX) BELLAIRE OUTPATIENT SURGERY CENTER LLPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$1269.001346205176 - CORAL DESERT SURGERY CENTER LLC710875262 - (UT) CORAL DESERT SURGERY CENTER LLCUTAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$2277.001922022425 - CASCADE SURGERY CENTER LLC202354326 - (OR) CASCADE SURGERY CENTER LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$1195.001023055001 - ZION AMBULATORY CENTER LLC203243084 - (MD) ZION AMBULATORY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$2509.001487609335 - THE CENTER FOR AESTHETIC SURGERY LLC200431536 - (MD) THE CENTER FOR AESTHETIC SURGERY LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23397$1485.001174859516 - HERMITAGE TN ENDOSCOPY ASC, LLC, ASSOCIATED ENDOSCOPY270986942TNAmbulatory 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 23397 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 23397 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 23397 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
23395-CPTHighTransfer Muscle Shoulder Single
23397-CPTHighMusc Txfr,Shldr/Arm Paralysis;Multi
23400-CPTHighScapulopexy
23420-CPTHighRep Avulsion Shoulder Cuff Chronic

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23397. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 23397 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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