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CPT 23605 Fee Schedule

Last Verified: January 2026

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.

Closed Treatment Of Proximal Humeral (Surgical Or Anatomical Neck) Fracture; With Manipulation, With Or Without Skeletal Traction
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

23 - Emergency Room

21 - Inpatient Hospital

Common Modifiers

None

54 - Surgical Care Only

RT - Right side of body

Complexity LevelModerate
Medicare Fee ScheduleView Medicare rates for 23605

National average reimbursement for CPT 23605 by major payers:

bcbs

$623.49

uhc

$622.17

aetna

$658.35

cigna

$790.68

Preview provider-level rates for...
For billing codeCPT 23605
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 23605

United
23605$1453.001609872597 - COLISEUM SAME DAY SURGERY CENTER LP621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LPGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$1400.001912447418 - LUBBOCK SURGERY CENTER, LLC812766547 - (TX) LUBBOCK SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$1156.001841342789 - SURGERY CENTER JV, THE SURGERY CENTER OF HUNTSVILLE621230866 - (AL) THE SURGERY CENTER OF HUNTSVILLEALAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$1654.001932438553 - MIDDLESEX CENTER FOR ADVANCED ORTHOPEDIC SURGERY263528303 - (CT) MIDDLESEX CENTER FOR ADVANCED ORTHOPEDIC SURGERYCTAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$830.001386792588 - WM DARRELL GASKINS LLC, NAPLES PREMIER SURGERY CENTER592484735 - (FL) WILLIAM DARRELL GASKINS, M.D.FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$2307.001588854772 - ALABAMA DIGESTIVE HEALTH ENDOSCOPY CENTER, LLC201243484 - (AL) ALABAMA DIGESTIVE HEALTHALAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$2307.001316508252 - MINIMALLY INVASIVE SURGICENTER LLC842130499 - (FL) MINIMALLY INVASIVE SURGICENTER LFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$2100.001003842626 - AMBULATORY CENTER FOR ENDOSCOPY, LLC200064962NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$1296.001245722883 - WOMENS HEALTH CENTER, HAMID ZADEH MD INC473398040 - (CA) WOMENS HEALTH CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$1443.001417217183 - PAULSEN STREET SUGERY CENTER LLC824075002GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$1025.001902876212 - SCAC LLC, SURGERY CENTER AT CRANBERRY562286973 - (PA) SCAC LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$2353.001881905792 - SURGCENTER PINELLAS, LLC271372259 - (FL) SURGCENTER PINELLAS, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$1191.001902981558 - LANE SURGERY CENTER, LLC931305103 - (OR) LANE SURGERY CENTER LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$1240.001811057029 - GREENSBORO NC ENDOSCOPY ASC LLC, GUILFORD ENDOSCOPY CENTER203802443 - (NC) GREENSBORO NC ENDOSCOPY ASC LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
23605$1628.001114952686 - NORTH RICHLAND HILLS ENDOSCOPY CENTER LLC, DIGESTIVE HEALTH CENTER OF NORTH RICHLAND HILLS203711547 - (TX) NORTH RICHLAND HILLS ENDOSCOPY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 23605 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 23605 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 23605 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.

CodeComplexityDescription
23570-CPTModerateClose Scapula Fract Wo Manip
23575-CPTModerateClosed Treatment Of Scapular Fracture; With Manipulation, With Or Without Skeletal Traction (With Or Without Shoulder Joint Involvement)
23585-CPTHighRed Fx Open-Scapula Juxta-Articular
23605-CPTModerateClosed Treatment Of Proximal Humeral (Surgical Or Anatomical Neck) Fracture; With Manipulation, With Or Without Skeletal Traction

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23605. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 23605 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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