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See a sample rate comparisonCPT 23625 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.
Closed Treatment Of Greater Hu, Closed Treatment Of Greater Humeral Tuberosity Fracturewith Manipulation Closed Treatment Of Greater Humeral Tuberosity Fracture
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 23 - Emergency Room 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None 54 - Surgical Care Only LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23625 |
| Medicaid Fee Schedule | View Medicaid rates for 23625 |
National average reimbursement for CPT 23625 by major payers:
$504.76
$507.03
$541.95
$629.17
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CPT 23625
5 of 25 sample ratesHigher to lower in this preview
Saint Lukes-Gi Diagnostics LLC
Saint Lukesgi Diagnostics LLC
$2,382.00Published rateGoshen Health Surgery Center, LLC
Goshen Health Surgery Center LLC
$1,208.00Published rateWinchester Eye Surgery Center, LLC
$800.00Published rateMichael Daum
Deaconess Hospital Inc
$663.86Published rateDewey Driscoll
Deaconess Hospital Inc
$305.01Published rate
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See a sample payer proposalCPT 23625 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23625 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 23625 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 |
| 23620-CPT | Moderate | Closed Treatment Of Greater Hu, Closed Treatment Of Greater Humeral Tuberosity Fracturewithout Manipulation Closed Treatment Of Greater Humeral Tuberosity Fracture |
| 23625-CPT | Moderate | Closed Treatment Of Greater Hu, Closed Treatment Of Greater Humeral Tuberosity Fracturewith Manipulation Closed Treatment Of Greater Humeral Tuberosity Fracture |
| 23630-CPT | High | Repair Broken Shoulder, Surgery To Repair A Broken Shoulder Involving The End Of The Bone In The Upper Arm (Humerus). This May Involve The Use Of Wires Pins Plates Rings Or Screws To Hold The Bone Together. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23625. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23625 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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