CPT 23515 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 23515 by major payers:
$960.77
$950.01
$1,025.38
$1,197.75
| 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 23515 | ||||||
United | 23515 | $3127.00 | 1063935286 - CHESNUT INSTITUTE OF COSMETIC & RECONSTRUCTIVE SURGERY | 821592877 - (WA) CLINIC 5C | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $1837.00 | 1275595746 - REGIONAL SURGICAL CENTRE, INC. | 640911313 - (MS) REGIONAL SURGICAL CENTRE INC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $4134.00 | 1114302353 - POINT OF ROCKS SURGERY CENTER, LLC | 464992977 - (MD) POINT OF ROCKS SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $7229.00 | 1336649565 - ADVANCED SURGICAL CARE OF ST. LOUIS, LLC | 823086965 - (MO) ADVANCED SURGICAL CARE OF ST LOUIS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $1300.00 | 1609803204 - AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC, AFFILIATED ENDOSCOPY SERVICES OF CLIFTON | 270064844 - (NJ) AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $3225.00 | 1740918887 - ORTHOMIDWEST SURGERY CENTER BELOIT, LLC | 881260648 - (WI) ORTHOMIDWEST SURGERY CENTER BELOIT LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $3000.00 | 1336649714 - HEALTHQARE SERVICES ASC LLC, HEALTHQARE SERVICES ASC LLC | 815460194 - (VA) HEALTHQARE SERVICES ASC LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $4189.00 | 1366044596 - PEGASUS SURGERY CENTER LLC, PEGASUS SURGERY CENTER, LLC | 301211930 - (CA) PEGASUS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $5121.00 | 1063720365 - WASATCH FRONT SURGERY CENTER LLC | 800612279 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $3297.00 | 1033734785 - CARDIOVASCULAR INSTITUTE OF THE SOUTH ASC, LLC | 850871914 - (LA) CARDIOVASCULAR INSTITUTE OF THE SOUTH ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $6492.00 | 1336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $4002.00 | 1245288257 - SURGICAL CENTER OF GREENSBORO, LLC | 631251243 - (NC) SURGICAL CENTER OF GREENSBORO LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $6087.00 | 1598767154 - NORTHWEST GEORGIA ORTHOPAEDIC SURGERY CENTER, LLC | 582132641 - (GA) NORTHWEST GEORGIA ORTHOPAEDIC SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $1203.00 | 1578525283 - PRINCETON ENDOSCOPY CENTER LLC | 200445094 - (NJ) PRINCETON ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23515 | $4951.00 | 1073908604 - ADVANCED SURGICAL GROUP, INC. | 464709919 - (CA) ADVANCED SURGICAL GROUP INC | CA | 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 23515 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23515 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 23515 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) |
| 23500-CPT | Moderate | Close Clavicle Fract Wo Manip |
| 23515-CPT | Moderate | Red Fx Open-Clavicle |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23515. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23515 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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