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See a sample rate comparisonCPT 23397 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.
Musc Txfr,Shldr/Arm Paralysis;Multi
| 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 23397 |
| Medicaid Fee Schedule | View Medicaid rates for 23397 |
National average reimbursement for CPT 23397 by major payers:
$1,598.85
$1,546.52
$1,556.22
$1,864.95
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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 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.
| 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. |
| 23420-CPT | High | 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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