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CPT 23500 Fee Schedule

Last Verified: December 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Close Clavicle Fract Wo Manip
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

23 - Emergency Room

11 - Office

Common Modifiers

None

54 - Surgical Care Only

LT - Left side of body

Complexity LevelModerate

National average reimbursement for CPT 23500 by major payers:

bcbs

$313.68

uhc

$290.16

aetna

$320.55

cigna

$372.91

Preview provider-level rates for...
For billing codeCPT 23500
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 23500

United
23500$176.001689699597 - NAPA SURGERY CENTER LLC680366295 - (CA) NAPA SURGERY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$673.001720001928 - CAMPBELL CLINIC SURGERY CENTER, LLC621826300TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$1831.001952331092 - MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLP203233617 - (TX) MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$63.001427028919 - CASCADE ENDOSCOPY CENTER, LLC, CASCADE ENDOSCOPY CENTER931331197 - (OR) CASCADE ENDOSCOPY CENTER, LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$1446.001578530226 - PHYSICIANS SURGICAL CENTER OF FT. WORTH LLP, BAYLOR SCOTT & WHITE SURGICARE FORT WORTH208303422 - (TX) PHYSICIANS SURGICAL CENTER OF FT WORTH LLPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$455.001972556942 - CHERRY HILL WOMEN'S CENTER, INC.232068660 - (NJ) CHERRY HILL WOMENS CENTER INCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$618.001316317134 - SUMMER STREET ASC LLC474990107 - (CT) SUMMER STREET ASC LLCCTAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$365.001083674196 - VISION CARE CENTER OF IDAHO LLC820516189 - (ID) VISION CARE CENTER OF IDAHO LLCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$954.461043094527 - WAUKEE SURGERY CENTER LLC881808321 - (IA) WAUKEE SURGERY CENTER LLCIAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$906.001447364682 - RIDGE VIEW ENDOSCOPY CENTER800688043COAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$906.001922160357 - ARAPAHOE ENDOSCOPY CENTER PARTNERSHIP PLLP472388780COAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$1744.001619245230 - AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC800768614 - (NJ) AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$250.001750920591 - HAYDEN SURGICAL CENTER LLC844085494 - (AZ) HAYDEN SURGICAL CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$108.001225745870 - APOLLO SURGICAL CENTER LLC922033557 - (AZ) APOLLO SURGICAL CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
23500$174.861023416252 - JODY SUTTON350593390 - DEACONESS HOSPITAL INCINCertified Registered Nurse Anesthetist (367500000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 23500 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 23500 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 23500 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.

CodeComplexityDescription
23480-CPTHighOsteotomy,Clavic,W/Wo Internal Fix;
23485-CPTHighOsteotomy, Clavicle, With Or Without Internal Fixation; With Bone Graft For Nonunion Or Malunion (Includes Obtaining Graft And/Or Necessary Fixation)
23490-CPTHighProphy Tx W/Wo M.Methacrylate;Clav
23500-CPTModerateClose Clavicle Fract Wo Manip

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23500. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 23500 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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