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See a sample rate comparisonCPT 23455 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.
Repair Shoulder Capsule, Reattachment Of Shoulder Joint Capsule And Cartilage Without Bone Transfer With Repair Of Shoulder Rim
| Key Fact | Detail |
|---|---|
| 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 Level | High |
| Medicare Fee Schedule | View Medicare rates for 23455 |
| Medicaid Fee Schedule | View Medicaid rates for 23455 |
National average reimbursement for CPT 23455 by major payers:
$1,322.48
$1,359.11
$1,391.24
$1,635.43
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CPT 23455
5 of 25 sample ratesHigher to lower in this preview
Central Louisiana Ambulatory Surgical Center LLC
Central Louisiana Surgical Hospital, LLC
$8,662.00Published rateUniversity Center For Ambulatory Surgery, LLC
University Center For Ambulatory Surgery LLC
$4,966.00Published ratePhoenix Spine And Joint Gilbert Asc, LLC
$4,033.00Published rateAtlanta Surgery Centers, Atlanta Surgery Centers
$2,824.00Published rateMsc Ambulatory Surgical Center
$1,587.00Published rate
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See a sample payer proposalCPT 23455 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23455 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 23455 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 |
|---|---|---|
| 23450-CPT | High | Capsulorrhaphy Anterio; Putti-Platt Proc Or Magnuson Typ Opera, Capsulorrhaphy Anterior; Putti-Platt Procedure Or Magnuson Type Opera |
| 23455-CPT | High | Repair Shoulder Capsule, Reattachment Of Shoulder Joint Capsule And Cartilage Without Bone Transfer With Repair Of Shoulder Rim |
| 23460-CPT | High | Capsul-Recur.Disloc,Any;Bone Block |
| 23462-CPT | High | Capsulorrhaphy Anterio Any Typ; W/ Coracoid Process Trnsfer, Capsulorrhaphy Anterior Any Type; With Coracoid Process Transfer |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23455. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23455 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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