CPT 23620 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 11 - Office • 23 - Emergency Room |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23620 |
National average reimbursement for CPT 23620 by major payers:
$375.39
$355.66
$372.46
$459.74
| 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 23620 | ||||||
United | 23620 | $648.00 | 1275281370 - MASS GENERAL BRIGHAM AMSURG INC. | 854372153 - (NH) MASS GENERAL BRIGHAM INCORPORATED | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $454.00 | 1952405284 - CHILDRENS HEALTH CARE SERVICES INC, CHILDRENS MINNETONKA | 411756478 - (MN) CHILDRENS HEALTH CARE SERVICES INC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $274.00 | 1982793709 - GASTROENTEROLOGY ASSOCIATES OF FAIRFIELD PC, ENDOSCOPY CENTER OF FAIRFIELD | 60867113 - (CT) GASTROENTEROLOGY ASSOCIATES OF FAIRFIELD, P.C. | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $566.00 | 1154474583 - CREEKWOOD SURGERY CENTER, LP | 431656044 - (MO) CREEKWOOD SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $289.00 | 1184699878 - NOC SURGERY CENTER LLC, LOC SURGERY CENTER | 470877119 - (NE) NOC SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $1814.00 | 1043275183 - FOREST AMBULATORY SURGICAL ASSOCIATES LLC, FOREST SURGERY CENTER | 942934248 - (CA) FOREST AMBULATORY SURGICAL ASSOCIATES, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $232.00 | 1639498454 - NEW VISTA HEALTH, LLC, PINEY POINT SURGERY CENTER | 272416864 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $566.00 | 1063947422 - SILVER CROSS AMBULATORY SURGERY CENTER, LLC, SILVER CROSS SURGERY CENTER | 371852055 - (IL) SILVER CROSS AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $250.00 | 1962609560 - FRONT RANGE ENDOSCOPY CENTERS, LLC | 205008349 - (CO) FRONT RANGE ENDOSCOPY CENTERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $531.00 | 1134126097 - PHYSICIAN'S SURGERY CENTER OF KNOXVILLE LLC | 621777892 - (TN) PHYSICIANS SURGERY CENTER OF KNOXVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $55.00 | 1043396245 - WEST FLORIDA MEDICAL CENTER CLINIC PA, MEDICAL CENTER CLINIC AMBULATORY SURGICAL CENTER | 592193856 - (FL) WEST FLORIDA MEDICAL CENTER CLINIC, P.A. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $929.00 | 1861059818 - FISHERS SPECIALTY SURGERY CENTER, LLC, ORTHOALLIANCE OF INDIANA | 833241405 - (IN) FISHERS SPECIALTY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $1096.00 | 1063598597 - CLEAR CREEK SURGERY CENTER LLC | 200871085 - (CO) CLEAR CREEK SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $84.00 | 1598921819 - THE PHYSICIANS' NORTH ATLANTA SURGERY CENTER LLC | 204676137 - (GA) THE PHYSICIANS NORTH ATLANTA SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23620 | $574.00 | 1801146535 - SURGCENTER AT PARADISE VALLEY, LLC, SURGCENTER AT PIMA CROSSING | 455364868 - (AZ) SURGCENTER AT PARADISE VALLEY | AZ | 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 23620 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23620 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 23620 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 23620. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23620 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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