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See a sample rate comparisonCPT 23410 Fee Schedule
Medicare rates as of October 2026
CPT 23410 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| 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 | 03600975Sign up to view all 6 |
| Medicare Fee Schedule | $764.88 national non-facility rate (2026)View Medicare rates for 23410 |
| Medicaid Fee Schedule | $610.015 median of the 8 states in the free previewView Medicaid rates for 23410 |
National average reimbursement for CPT 23410 by major payers:
$1,130.65
BCBS / Anthem
$1,130.40
UnitedHealthcare
$1,171.94
Aetna
$1,362.82
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 23410.
CPT 23410
5 of 25 sample ratesHigher to lower in this preview
Reston Surgery Center, Lp
Reston Surgery Center Lp
$6,281.00Published rateVivere Health Austin, LLC, Vivere Austin Surgery Center
Vivere Health Austin LLC
$4,312.00Published rateDcr Surgery Center, LLC
Dcr Surgery Center LLC
$2,800.00Published rateHea Gramercy Surgery Center, PLLC, Hea Surgery Center
$2,400.00Published rateCentral Ohio Endoscopy Center, LLC
Central Ohio Endoscopy Center LLC
$747.00Published rate
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See a sample payer proposalCPT 23410 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 23410. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 23400-CPT | Reposition Shoulder Blade, Surgery To Reposition The Shoulder Blade (Scapula) And Reorient The Associated Muscles And Tendons. |
| 23405-CPT | Tenomyotomy, Shoulder Area; Single |
| 23406-CPT | Tenotomy Shlder Area; Multi Tendons Through Same Ncision, Tenotomy Shoulder Area; Multiple Tendons Through Same Incision |
| 23410-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 23410. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23410 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 23410 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 23410 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 23410 in an ambulatory surgery center?
CMS lists CPT 23410 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 23410?
Hospital price transparency files list CPT 23410 under these revenue codes: including 0360, 0975, 0960, 0989 and 0490. A revenue code names the hospital department or charge category for the line; it does not change what the service is.