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See a sample rate comparisonCPT 23460 Fee Schedule
Medicare rates as of October 2026
CPT 23460 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Capsul-Recur.Disloc,Any;Bone Block
| 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) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 03600960 |
| Medicare Fee Schedule | $1,000.69 national non-facility rate (2026)View Medicare rates for 23460 |
| Medicaid Fee Schedule | $795.36 median of the 8 states in the free previewView Medicaid rates for 23460 |
National average reimbursement for CPT 23460 by major payers:
$1,444.13
BCBS / Anthem
$1,481.43
UnitedHealthcare
$1,542.94
Aetna
$1,787.99
Cigna
Compare published rates across providers.
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CPT 23460
5 of 25 sample ratesHigher to lower in this preview
South Austin Surgery Center Ltd
$6,721.00Published rateSame Day Sc Of Central Nj LLC
$5,758.00Published rate4th Street Laser & Surgery Center Inc
Fourth Street Laser & Surgery
$3,572.00Published rateCataract And Laser Center Associates PC
$2,665.00Published rateCatalina Surgery Center, LLC
Catalina Surgery Center LLC
$1,024.00Published rate
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See a sample payer proposalCPT 23460 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 23460. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 23455-CPT | Repair Shoulder Capsule, Reattachment Of Shoulder Joint Capsule And Cartilage Without Bone Transfer With Repair Of Shoulder Rim |
| 23460-CPT | Capsul-Recur.Disloc,Any;Bone Block |
| 23462-CPT | Capsulorrhaphy Anterio Any Typ; W/ Coracoid Process Trnsfer, Capsulorrhaphy Anterior Any Type; With Coracoid Process Transfer |
| 23466-CPT | Capsulorrhaphy Glenohumral Joint Any Typ Multi-Direct Instabi, Capsulorrhaphy Glenohumeral Joint Any Type Multi-Directional Instabi |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23460. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23460 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 23460 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 23460 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 23460 in an ambulatory surgery center?
CMS lists CPT 23460 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 23460?
Hospital price transparency files list CPT 23460 under these revenue codes: 0360 and 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.