CPT 23585 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 23585 by major payers:
$1,357.31
$1,277.59
$1,350.72
$1,599.46
| 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 23585 | ||||||
United | 23585 | $4000.00 | 1184009326 - AMBULATORY CENTER FOR ENDOSCOPY, LLC, HUDSON BERGEN ENDO-SURGICAL CENTER | 200064962 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $1848.00 | 1336170596 - THE UROLOGIC SURGICAL CENTER LLC | 562354405 - (PA) THE UROLOGIC SURGICAL CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $6087.00 | 1386086411 - MARION SURGERY CENTER, LLC | 462447139 - (FL) MARION SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $1752.00 | 1720388465 - WEST ASC, LLC, CAMILLUS SURGERY CENTER | 273166743 - (NY) WEST ASC, LLC DBA CAMILLUS SURGERY CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $6588.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $3339.00 | 1730374307 - NORTHVIEW ORTHOPAEDIC SURGERY CENTER, P.C. | 261245423 - (GA) NORTHVIEW ORTHOPAEDIC SURGERY CENTER PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $995.00 | 1033426580 - ADVANCED AMBULATORY SURGERY CENTER, LLC | 271607092 - (IN) ADVANCED AMBULATORY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $2059.00 | 1720262405 - BATON ROUGE LA ENDOSCOPY ASC LLC, LOUISIANA ENDOSCOPY CENTER | 261168310 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $3240.00 | 1063750867 - MENLO PARK SURGERY CENTER, LLC. | 263669436 - (NJ) MENLO PARK SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $2942.00 | 1093287302 - WHEELING HOSPITAL AMBULATORY SURGERY CENTER LLC | 832914078 - (OH) WHEELING HOSPITAL AMBULATORY SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $4474.00 | 1023271459 - RIVERBEND AMBULATORY SURGERY CENTER LLC, DAY SURGERY AT RIVERBEND | 205575145 - (OR) RIVERBEND AMBULATORY SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $4162.00 | 1417919879 - HUNTERDON ENDOSURGERY CENTER | 223597546 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $9789.00 | 1871033878 - REDMOND AMBULATORY SURGERY CENTER, LLC | 813558711 - (WA) REDMOND AMBULATORY SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $7888.00 | 1366406233 - MIDDLE TENNESSEE AMBULATORY SURGERY CENTER, L.P. | 621699667 - (TN) MIDDLE TENNESSEE AMBULATORY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23585 | $5835.00 | 1932530284 - VP SURGERY CENTER OF AUBURN LLC | 371668651 - (WA) VP SURGERY CENTER OF AUBURN LLC | WA | 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 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 | 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 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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