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CPT 23412 Fee Schedule

Last Verified: February 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.

Rep Rupture Supraspin Tendon Chron
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

24 - Ambulatory Surgical Center

22 - On Campus Outpatient Hospital

Common Modifiers

None

RT - Right side of body

LT - Left side of body

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 23412

National average reimbursement for CPT 23412 by major payers:

bcbs

$1,136.47

uhc

$1,180.75

aetna

$1,227.56

cigna

$1,455.52

Preview provider-level rates for...
For billing codeCPT 23412
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 23412

United
23412$3914.001790130672 - PROSPECT DCMH, LLC, SHORT PROCEDURE UNIT811520273PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$1982.001790167740 - TIDALHEALTH SURGERY CENTER, LLC474184623MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$4074.001861782591 - CENTER FOR AMBULATORY AND MINIMALLY INVASIVE SURGERY LLC, CAMIS270907140 - (NJ) CENTER FOR AMBULATORY AND MININJAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$5249.001588854772 - ALABAMA DIGESTIVE HEALTH ENDOSCOPY CENTER, LLC201243484 - (AL) ALABAMA DIGESTIVE HEALTHALAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$2504.001558344846 - ALGONQUIN ROAD SURGERY CENTER, LLC364337493 - (IL) ALGONQUIN ROAD SURGERY CENTERILAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$5354.001407275282 - SURGCENTER CAMELBACK LLC464169482 - (AZ) SURGCENTER CAMELBACK LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$9476.001063427557 - CAMPUS SURGERY CENTER LLC134334643 - (CA) CAMPUS SURGERY CENTER L PCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$1919.001730570003 - SMART PAIN SURGERY CENTER AT GERMANTOWN, LLC, CLEARWAY SURGERY CENTER OF GERMANTOWN472908671 - (MD) SMART PAIN SURGERY CENTER AT GERMANTOWN LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$5433.001891298089 - MICHIGAN OUTPATIENT SURGICAL SOLUTIONS, LLC821706937 - (MI) MICHIGAN OUTPATIENT SURGICAL SOLUTIONS LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$1903.651417916800 - TULSA OK ENDOSCOPY ASC LLC, TULSA ENDOSCOPY CENTER203853559 - (OK) TULSA ENDOSCOPY CENTER, LLCOKAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$1100.001871204511 - LAWRENCEVILLE CENTER FOR PAIN AND SPINE, LLC920689448 - (GA) LAWRENCEVILLE CENTER FOR PAIN AND SPINE LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$1259.001275564346 - CEDAR OAKS SURGERY CENTER LLC450528697 - (MO) CEDAR OAKS SURGERY CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$1950.001922280197 - NORTH OAK AMBULATORY SURGERY CENTER, LLC261479859GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$4272.001700838471 - SANTA CRUZ SURGERY CENTER770194916 - (CA) SANTA CRUZ SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23412$520.001558372029 - HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P593591411 - (FL) HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L PFLAmbulatory 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 23412 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 23412 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 23412 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
23410-CPTHighRepr Rupt-Supraspin Ten/Cuff;Acute
23412-CPTHighRep Rupture Supraspin Tendon Chron
23415-CPTModerateCorocoacromial Lig Rel W/Wo Plsty
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 23412. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 23412 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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