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See a sample rate comparisonCPT 23615 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 23615 |
| Medicaid Fee Schedule | View Medicaid rates for 23615 |
National average reimbursement for CPT 23615 by major payers:
$1,235.66
$1,175.19
$1,250.93
$1,435.62
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CPT 23615
5 of 25 sample ratesHigher to lower in this preview
Canonsburg General Hospital
Highmark Health
$34,728.39Published rateMedstar Surgery Center At Timonium, LLC
Medstar Surgery Center At Timo
$4,264.00Published rateMuve
$3,150.00Published rateAdvanced Surgery Center Of Palm Beach County, LLC, Advanced Surgery Center
Advanced Surgery Center Of Palm Beach County LLC
$1,820.00Published rateLindsay Lang
Deaconess Hospital Inc
$707.40Published rate
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See a sample payer proposalCPT 23615 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23615 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 23615 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 |
|---|---|---|
| 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. |
| 23620-CPT | Moderate | Closed Treatment Of Greater Hu, Closed Treatment Of Greater Humeral Tuberosity Fracturewithout Manipulation Closed Treatment Of Greater Humeral Tuberosity Fracture |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23615. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23615 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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