CPT 23615 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 • 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 |
National average reimbursement for CPT 23615 by major payers:
$1,235.66
$1,175.19
$1,250.93
$1,478.05
| 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 23615 | ||||||
United | 23615 | $2854.00 | 1598339392 - COPPER CITY SURGERY CENTER, PLLC | 831039743 - (MT) COPPER CITY SURGERY CENTER PLLC | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $3605.00 | 1720048242 - MARYLAND SURGERY CENTER FOR WOMEN LLC, MARYLAND SURGERY CENTER | 522215638 - (MD) MARYLAND SURGERY CENTER FOR WOMEN, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $4461.00 | 1578221479 - SKIN CANCER AND LASER SURGERY CENTER LLC | 854119523 - (IN) SKIN CANCER AND LASER SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $4067.00 | 1720566433 - PAVILION SURGICENTER, LLC, PHYSICIANS PAVILION SURGERY CENTER | 830619935 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $2960.00 | 1992192488 - WEST PACES SURGERY CENTER LLC | 473360333 - (GA) WEST PACES SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $707.40 | 1033116314 - LINDSAY LANG | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 23615 | $34728.39 | 1710007596 - CANONSBURG GENERAL HOSPITAL | 251737079 - (PA) HIGHMARK HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $4162.00 | 1538389812 - IRONBOUND ENDO SURGICAL CENTER, INC. | 223651393 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $2891.00 | 1720099260 - MEAH ASC MANAGEMENT, LLC | 760663270 - (TX) MEAH ASC MANAGEMENT LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $14053.00 | 1396774543 - WISCONSIN SURGERY CENTER LLC | 383661215 - (WI) WISCONSIN SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $768.00 | 1487651956 - TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC, TRI-STATE DIGESTIVE DISORDER CENTER | 611192347 - (KY) TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $2306.00 | 1578643607 - PAIN CENTER LLC | 331048492 - (AR) THE PAIN CENTER OF JONESBORO, LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $1820.00 | 1194987222 - ADVANCED SURGERY CENTER OF PALM BEACH COUNTY, LLC, ADVANCED SURGERY CENTER | 262830080 - (FL) ADVANCED SURGERY CENTER OF PALM BEACH COUNTY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $1040.00 | 1306963020 - BATTLE CREEK ENDOSCOPY & SURGERY LLC | 201914507 - (MI) BATTLE CREEK ENDOSCOPY & SURGERY CENTER PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23615 | $1765.00 | 1003871104 - MEMPHIS SURGERY CENTER LTD, LP, MEMPHIS SURGERY CENTER | 621218330 - (TN) MEMPHIS SURGERY CENTER, LTD, LP | TN | 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 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 | Close Prox Humeral Fract Wo Manip |
| 23605-CPT | Moderate | Closed Treatment Of Proximal Humeral (Surgical Or Anatomical Neck) Fracture; With Manipulation, With Or Without Skeletal Traction |
| 23615-CPT | High | Open Treatment Of Proximal Humeral (Surgical Or Anatomical Neck) Fracture Includes Internal Fixation When Performed Includes Repair Of Tu Berosity(S) When Performed; |
| 23620-CPT | Moderate | Close Great Tuber 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 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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