Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 23605 Fee Schedule
Last Verified: October 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.
Cltx Prx Hmrl Fx Mnpj Tract, Closed Treatment Of Proximal Humeral Surgical Or Anatomical Neck Fracture With Manipulation With Or Without Skeletal Traction
| Key Fact | Detail |
|---|---|
| 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 Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23605 |
| Medicaid Fee Schedule | View Medicaid rates for 23605 |
National average reimbursement for CPT 23605 by major payers:
$623.49
$622.17
$658.35
$790.68
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 23605.
CPT 23605
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Richmond, LLC, Memorial Hermann Surgery Center Richmond
$5,729.00Published rateMiddlesex Center For Advanced Orthopedic Surgery
$1,654.00Published rateLubbock Surgery Center, LLC
Lubbock Surgery Center LLC
$1,400.00Published rateHeart Care Center, LLC
$1,148.00Published rateWm Darrell Gaskins LLC, Naples Premier Surgery Center
William Darrell Gaskins, M.D.
$830.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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.
| 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 |
| 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 |
| 23605-CPT | Moderate | Cltx Prx Hmrl Fx Mnpj Tract, Closed Treatment Of Proximal Humeral Surgical Or Anatomical Neck Fracture With Manipulation With Or Without Skeletal Traction |
| 23615-CPT | High | Surgical Repair Of Broken Arm, Surgery To Repair A Broken Upper Arm Bone (Humerus). The Procedure Can Involve The Use Of Wires Pins Plates Rings Or Screws To Hold The Bone Together. Repair May Include A Prosthesis Or Implant. |
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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 23605) and we'll show you how you compare in 15 minutes or less.