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See a sample rate comparisonCPT 23460 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.
Capsul-Recur.Disloc,Any;Bone Block
| 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 23460 |
| Medicaid Fee Schedule | View Medicaid rates for 23460 |
National average reimbursement for CPT 23460 by major payers:
$1,444.13
$1,481.43
$1,542.94
$1,787.99
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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 CPT 23460 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 23460 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 |
|---|---|---|
| 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 |
| 23466-CPT | High | 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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