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See a sample rate comparisonCPT 23585 Fee Schedule
Last Verified: October 2026
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.
Broken Shoulder Blade Surgery, Surgery To Repair A Broken Shoulder Blade (Scapula). The Procedure May Involve Holding The Bones Together With Pins Or Wires.
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 23585 |
| Medicaid Fee Schedule | View Medicaid rates for 23585 |
National average reimbursement for CPT 23585 by major payers:
$1,357.31
$1,277.59
$1,350.72
$1,562.29
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CPT 23585
5 of 25 sample ratesHigher to lower in this preview
Redmond Ambulatory Surgery Center, LLC
Redmond Ambulatory Surgery Center LLC
$9,789.00Published rateMarion Surgery Center, LLC
Marion Surgery Center LLC
$6,087.00Published rateHunterdon Endosurgery Center
$4,162.00Published rateBaton Rouge La Endoscopy Asc LLC, Louisiana Endoscopy Center
$2,059.00Published rateLaser And Vision Surgery Center, LLC
Laser And Vision Surgery Center LLC
$720.00Published rate
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See a sample payer proposalCPT 23585 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23585 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 23585 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 | Closed Treatment Of Scapular F, Closed Treatment Of Scapular Fracture Without Manipulation Closed Treatment Of Scapular Fracture Without Manipulation |
| 23575-CPT | Moderate | Cltx Scap Fx W/Mnpj +-Tractj, Closed Treatment Of Scapular Fracture; With Manipulation With Or Without Skeletal Traction (With Or Without Shoulder Joint Involvement) |
| 23585-CPT | High | Broken Shoulder Blade Surgery, Surgery To Repair A Broken Shoulder Blade (Scapula). The Procedure May Involve Holding The Bones Together With Pins Or Wires. |
| 23600-CPT | Moderate | Closed Treatment Of Proximal H, Closed Treatment Of Proximal Humeral (Surgical Or Anatomicalneck) Fracture Without Manipulation Closed Treatment Of Proximal Humeral (Surgical Or Anatomical |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23585. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23585 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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