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See a sample rate comparisonCPT 23470 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.
Arthroplasty Glenohumeral Joi, Arthroplasty Glenohumeral Joint Hemiarthroplastyarthroplasty Glenohumeral Joint Hemiarthroplasty
| 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 23470 |
| Medicaid Fee Schedule | View Medicaid rates for 23470 |
National average reimbursement for CPT 23470 by major payers:
$1,696.71
$1,634.96
$1,704.09
$1,968.63
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CPT 23470
5 of 25 sample ratesHigher to lower in this preview
Fairfax Surgical Center, L.P.
Fairfax Surgical Center Lp
$25,946.00Published rateSurgcenter Of Silver Spring, LLC
Surgcenter Of Silver Spring LLC
$9,324.00Published rateTexas Regional Eye Center Asc LLC, Texas Regional Eye Center Asc LLC
Texas Regional Eye Center Asc LLC
$5,038.00Published rateBaptist Medical Park Surgery Center, LLC
Baptist Medical Park Surgery Center LLC
$3,093.00Published ratePuget Sound Gastroenterology, PLLC, Edmonds Endoscopy Center
Puget Sound Gastroenterology, P.S.
$1,189.00Published rate
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See a sample payer proposalCPT 23470 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23470 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 23470 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 |
|---|---|---|
| 23470-CPT | High | Arthroplasty Glenohumeral Joi, Arthroplasty Glenohumeral Joint Hemiarthroplastyarthroplasty Glenohumeral Joint Hemiarthroplasty |
| 23472-CPT | High | Surgical Service Bundle Includes All Surgery Related Health Services Which Are Incurred In Connection With An Approved Outpatient Surgical Procedure, Billed Via The Agreed Upon Cpt Codes And Reimbursed At A Single Payment Rate Including All Services Such |
| 23473-CPT | High | Fix Shoulder Replacement, Surgery To Fix An Artificial Shoulder Replacement That Was Done Sometime In The Past. The Procedure May Include Transplanting Tissue. |
| 23474-CPT | High | Fix Shoulder Replacement, Surgery To Fix An Artificial Shoulder Replacement That Was Done Sometime In The Past. The Procedure May Include Transplanting Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23470. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23470 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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