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See a sample rate comparisonCPT 23465 Fee Schedule
Last Verified: October 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.
Capsulorrhaphy Glenohumral Joint Posteri W//W/O Bone Bl, Capsulorrhaphy Glenohumeral Joint Posterior With Or Without Bone Bl
| 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 23465 |
| Medicaid Fee Schedule | View Medicaid rates for 23465 |
National average reimbursement for CPT 23465 by major payers:
$1,521.48
$1,516.22
$1,538.59
$1,830.01
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CPT 23465
5 of 25 sample ratesHigher to lower in this preview
Texas Health Surgery Center Willow Park LLC, Texas Health Orthopedic And Spine Surgery Center
Texas Health Surgery Center Willow Park LLC
$8,238.00Published rateBoulevard Ent Surgery Center LLC
$4,184.00Published ratePark Ridge Surgery Center, LLC
Park Ridge Surgery Center LLC
$2,781.00Published rateMercer County Surgery Center LLC, Mercer County Surgery Center
Mercer County Surgery Center, LLC
$1,942.00Published rateCherry Hill Women'S Center, Inc.
Cherry Hill Womens Center Inc
$980.00Published rate
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See a sample payer proposalCPT 23465 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23465 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 23465 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 |
|---|---|---|
| 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 |
| 23465-CPT | High | Capsulorrhaphy Glenohumral Joint Posteri W//W/O Bone Bl, Capsulorrhaphy Glenohumeral Joint Posterior With Or Without Bone Bl |
| 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 23465. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23465 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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