CPT 23570 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 | • 11 - Office • 21 - Inpatient Hospital • 23 - Emergency Room |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23570 |
National average reimbursement for CPT 23570 by major payers:
$325.84
$307.40
$328.86
$397.37
| 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 23570 | ||||||
United | 23570 | $83.00 | 1821010638 - CATARACT AND LASER CENTER LLC | 522066053 - (DE) CATARACT AND LASER CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $112.00 | 1720514359 - JOHNS HOPKINS SURGERY CENTERS SERIES, KNOLL NORTH SURGERY CENTER | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $425.00 | 1730603622 - DULUTH SURGICAL SUITES LLC | 820668583 - (MN) DULUTH SURGICAL SUITES LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $195.00 | 1841578978 - PHYSICIANS' SURGERY CENTER OF NEVADA LLC | 273741243 - (NV) PHYSICIANS SURGERY CENTER OF NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $186.00 | 1386749943 - QUAIL SURGICAL AND PAIN MANAGEMENT CENTER, LLC | 880391609 - (NV) QUAIL SURGICAL & PAIN MANAGEMENT CENTER, LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $100.00 | 1578508875 - CLERMONT AMBULATORY SURGICAL CENTER | 202139893 - (FL) CLERMONT AMBULATORY SURGICAL CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $175.00 | 1508986621 - ASHLAND SURGERY CENTER | 830346584 - (OR) ASHLAND SURGERY CENTER INC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $1047.00 | 1528335148 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS HOSPITALS FOR CHILDREN - ERIE AMBULATORY SURGERY CENTER | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $100.00 | 1013096700 - CLEARER VISION, LLC, PERIMETER SURGERY CENTER | 621792483 - (TN) CLEARER VISION, LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $108.00 | 1851317614 - KENDALL POINTE SURGERY CENTER LLC | 364236445 - (IL) KENDALL POINTE SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $400.00 | 1871033878 - REDMOND AMBULATORY SURGERY CENTER, LLC | 813558711 - (WA) REDMOND AMBULATORY SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $85.00 | 1386833044 - THE POTTSVILLE PA ENDOSCOPY ASC LP, SCHUYLKILL ENDOSCOPY CENTER | 260303896 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $555.00 | 1285815522 - TLC ASC, LLC, KZMSS AGAIN, LLLP | 201952603 - (FL) TLC ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $1301.00 | 1962681130 - BAYLOR SURGICARE AT PLANO, LLC, BAYLOR SCOTT & WHITE SURGICARE - PLANO | 260308454 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23570 | $100.00 | 1881276319 - TEXARKANA PAIN SURGERY CENTER LLC | 844941902 - (AR) TEXARKANA PAIN SURGERY CENTER LLC | AR | 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 23570 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23570 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 23570 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 |
|---|---|---|
| 23570-CPT | Moderate | Close Scapula Fract Wo Manip |
| 23575-CPT | Moderate | Closed Treatment Of Scapular Fracture; With Manipulation, With Or Without Skeletal Traction (With Or Without Shoulder Joint Involvement) |
| 23585-CPT | High | Red Fx Open-Scapula Juxta-Articular |
| 23600-CPT | Moderate | Close Prox Humeral 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 23570. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23570 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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