CPT 23480 Fee Schedule
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.
| 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 23480 by major payers:
$1,146.60
$1,110.82
$1,120.64
$1,379.45
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 23480 | ||||||
United | 23480 | $5779.00 | 1528339447 - CP SURGERY CENTER, LLC | 800776412 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $2000.00 | 1023567260 - SKI AMBULATORY SURGICAL CENTERS, LLC | 813831008 - (AZ) SKI AMBULATORY SURGICAL CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $3956.00 | 1538736459 - PONY CREEK ANNEX, LLC | 844833158 - (OR) PONY CREEK ANNEX LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $2305.00 | 1043680440 - SOUTHWEST MEDICAL ASSOCIATES, INC, SOUTHWEST MEDICAL ASSOCIATES - TENAYA | 880201420 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $5035.00 | 1447995311 - NEW ENGLAND BAPTIST SURGERY CENTER LLC | 874311329 - (MA) NEW ENGLAND BAPTIST SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $2109.00 | 1205878758 - ALBUQUERQUE AMBULATORY EYE SURGERY CENTER, LLC | 850481490 - (NM) ALBUQUERQUE AMBULATORY EYE SURGERY CENTER LLC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $3438.00 | 1558526293 - ENDOSCOPY CENTER OF THE ROCKIES LLC, ENDOSCOPY CENTER OF THE ROCKIES BOULDER | 841562782 - (CO) ENDOSCOPY CENTER OF THE ROCKIES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $5611.00 | 1528339447 - CP SURGERY CENTER, LLC | 800776412 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $5433.00 | 1942264619 - METROPOLITAN MEDICAL PARTNERS LLC, SURGERY CENTER OF CHEVY CHASE | 522303928 - (MD) METROPOLITAN MEDICAL PARTNERS LL | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $5020.00 | 1649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $7044.00 | 1730563610 - SACRAMENTO MIDTOWN ENDOSCOPY CENTER, LLC | 364811322 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $2800.00 | 1255793758 - MISSION SURGERY CENTER, INC. | 475137439 - (CA) MISSION SURGERY CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $1732.00 | 1508862160 - TRIAD SURGERY CENTER LLC, TRIAD EYE MEDICAL CLINIC AND CATARACT INSTITUTE PLLC | 473510624 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $6800.00 | 1366647968 - NORTH POINTE SURGERY CENTER, LP | 204435545 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23480 | $2274.00 | 1033135314 - MED ATLANTIC INC, MED ATLANTIC INC DBA UROSURGICAL CTR OF RICHMOND | 541759643 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 23480 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23480 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 23480 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 |
|---|---|---|
| 23480-CPT | High | Osteotomy,Clavic,W/Wo Internal Fix; |
| 23485-CPT | High | Osteotomy, Clavicle, With Or Without Internal Fixation; With Bone Graft For Nonunion Or Malunion (Includes Obtaining Graft And/Or Necessary Fixation) |
| 23490-CPT | High | Prophy Tx W/Wo M.Methacrylate;Clav |
| 23491-CPT | High | Prophylactic Treatment Prox Humerus |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23480. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23480 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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