CPT 23500 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| 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 Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23500 |
National average reimbursement for CPT 23500 by major payers:
$313.68
$290.16
$320.55
$372.91
| 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 23500 | ||||||
United | 23500 | $112.00 | 1891763157 - HOUMAS OUTPATIENT SURGERY CENTER | 721005613 - (LA) HOUMA OUTPATIENT SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $544.00 | 1164012142 - COMPREHENSIVE DIGESTIVE SURGICENTER, LLC, COMPREHENSIVE DIGESTIVE SURGICAL CENTER | 854015524 - (NV) COMPREHENSIVE DIGESTIVE SURGICENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $1744.00 | 1619245230 - AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC | 800768614 - (NJ) AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $2491.00 | 1275596264 - CAROLINA REGIONAL SURGERY CENTER. LTD | 621616402 - (SC) CAROLINA REGIONAL SURGERY CENTER LTD | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $1394.00 | 1023359627 - THE EMORY CLINIC INC., EMORY AESTHETIC CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $266.00 | 1962772871 - SURGERY CENTER OF NORTHEAST TEXAS LLC, SURGERY CENTER OF NORTHEAST TEXAS | 454184639 - (TX) SCNETX, LLCDBA SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $176.00 | 1689699597 - NAPA SURGERY CENTER LLC | 680366295 - (CA) NAPA SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $500.00 | 1942548870 - ISPM ASC AT CAMP CREEK LLC, ALLIANCE SURGERY CENTER AT CAMP CREEK | 461000991 - (GA) ISPM ASC AT CAMP CREEK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $108.00 | 1659408300 - CENTRE AVENUE GROUP, LLC, EAST SIDE SURGERY CENTER | 202831701 - (PA) CENTRE AVENUE GROUP, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $500.00 | 1992875454 - ELGIN GASTROENTEROLOGY ENDOSCOPY CENTER LLC, THE ENDO CENTER OF ELGIN GASTROENTEROLOGY | 200916460 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $267.00 | 1851531248 - LASER SURGERY HOLDING COMPANY, LTD | 550882748 - (AZ) LASER SURGERY HOLDING COMPANY LT | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $906.00 | 1922160357 - ARAPAHOE ENDOSCOPY CENTER PARTNERSHIP PLLP | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $566.00 | 1881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $81.00 | 1043268840 - PREMIERE SURGERY CENTER, INC | 330420108 - (CA) PREMIERE SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23500 | $688.00 | 1063092047 - TAMPA BAY JOINT AND SPINE, LLC, TAMPA BAY JOINT AND SPINE SURGERY CENTER | 851259146 - (FL) TAMPA BAY JOINT AND SPINE LLC | FL | 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 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.
| 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 |
| 23500-CPT | Moderate | Close 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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