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See a sample rate comparisonCPT 23630 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 23630 |
| Medicaid Fee Schedule | View Medicaid rates for 23630 |
National average reimbursement for CPT 23630 by major payers:
$1,056.47
$1,019.89
$1,071.76
$1,256.35
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CPT 23630
5 of 25 sample ratesHigher to lower in this preview
Red Cedar Surgery Center, LLC, Red Cedar Surgery Center, PLLC
Red Cedar Surgery Center, PLLC
$7,888.00Published rateEastern Pennsylvania Endoscopy Center, LLC
Eastern Pennsylvania Endoscopy Center LLC
$5,500.00Published rateVance Thompson Vision Surgery Center Billings, LLC
$3,240.00Published rateEndoscopy Center Of Grand Junction LLC
$2,363.00Published rateDigestive Health Complex,Inc
$675.00Published rate
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See a sample payer proposalCPT 23630 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23630 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 23630 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 23630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23630 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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