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See a sample rate comparisonCPT 23397 Fee Schedule
Medicare rates as of October 2026
CPT 23397 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Musc Txfr,Shldr/Arm Paralysis;Multi
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 24Ambulatory Surgical Center |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $1,042.78 national non-facility rate (2026)View Medicare rates for 23397 |
| Medicaid Fee Schedule | $828.285 median of the 8 states in the free previewView Medicaid rates for 23397 |
National average reimbursement for CPT 23397 by major payers:
$1,598.85
BCBS / Anthem
$1,546.52
UnitedHealthcare
$1,556.22
Aetna
$1,864.95
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 23397.
CPT 23397
5 of 25 sample ratesHigher to lower in this preview
Park Nicollet Methodist Hospital, Park Nicollet Same Day Surgery Center
Park Nicollet Health Services
$8,588.00Published rateBcc Chandler LLC
$4,014.00Published rateGulf Coast Outpatient Surgery Center, LLC
$2,441.00Published rateOutpatient Services East
Outpatient Services East Ltd
$1,650.00Published rateNorthern Arizona Eye Associates
$1,000.00Published rate
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See a sample payer proposalCPT 23397 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 23397. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 23395-CPT | Transfer Muscle Shoulder Single |
| 23397-CPT | Musc Txfr,Shldr/Arm Paralysis;Multi |
| 23400-CPT | Reposition Shoulder Blade, Surgery To Reposition The Shoulder Blade (Scapula) And Reorient The Associated Muscles And Tendons. |
| 23420-CPT | Rotator Cuff Repair Surgery, Surgery To Repair The Rotator Cuff Of The Shoulder. The Procedure May Involve Removing A Small Amount Of Bone Or Repairing Muscles And Ligaments In The Area. |
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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Frequently Asked Questions
What APC is CPT 23397 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 23397 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 23397 in an ambulatory surgery center?
CMS lists CPT 23397 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 23397?
Hospital price transparency files list CPT 23397 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.