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CPT 23655 Fee Schedule

Last Verified: January 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.

Close Shoulder Dis W Manip W Anes
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

23 - Emergency Room

21 - Inpatient Hospital

Common Modifiers

None

RT - Right side of body

LT - Left side of body

Complexity LevelModerate
Medicare Fee ScheduleView Medicare rates for 23655

National average reimbursement for CPT 23655 by major payers:

bcbs

$549.48

uhc

$530.26

aetna

$564.99

cigna

$679.16

Preview provider-level rates for...
For billing codeCPT 23655
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 23655

United
23655$438.001487627642 - SURGERY CENTER OF CORAL GABLES LLC, SURGERY CENTER OF CORAL GABLES LLC621827649FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$915.001366154304 - OPTUM CARE WASHINGTON PLLC, OPTUM - HELEN HOLM PUMPHREY SURGERY CENTER910214500 - THE EVERETT CLINIC, PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$701.841346774536 - AYSHA KHAN350593390 - DEACONESS HOSPITAL INCILInternal Medicine Physician (207R00000X)
United
23655$1525.001396896684 - DREYER AMBULATORY SURGERY CENTER, LLC363890298 - (IL) DREYER AMBULATORY SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$980.001295906956 - THE ENT CENTER OF RHODE ISLAND LLC, THE SURGERY CENTER OF RHODE ISLAND260329297 - (RI) THE ENT CENTER OF RHODE ISLANDRIAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$750.001033525779 - US CARDIO OF SA, LLC465144655 - (TX) US CARDIO OF SA LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$485.001811059306 - PENINSULA EYE CENTER, P.A, PENINSULA CATARACT & LASER CENTER520974706 - (MD) PENINSULA EYE CENTER PAMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$600.001770528838 - BREVARD SURGERY CENTER593128478 - (FL) BREVARD SURGERY CENTERFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$2782.001699738112 - NORTH AUSTIN SURGERY CENTER, L.P.200648730 - (TX) NORTH AUSTIN SURGERY CENTER LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$810.001689633588 - SOUTH JERSEY ENDOSCOPY LLC, DIMARINO-KROOP-PRIETO GI ASSOC200478348 - (NJ) SOUTH JERSEY ENDOSCOPY LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$732.001619998523 - UPSTATE SURGERY CENTER, LLC562186977 - (SC) UPSTATE SURGERY CENTER LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$770.001982975959 - ARCHIBALD SURGERY CENTER, LLC453730425 - (CA) ARCHIBALD SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$700.001598144909 - TRINITY AMBULATORY SURGICAL CENTER LLC, HEART & RHYTHM INSTITUTE OF TRINITY472090172 - (FL) TRINITY AMBULATORY SURGICAL CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$606.001497314181 - OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS, LLC832118109 - (IL) OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
23655$701.841730412826 - RAMIN RASHIDIAN350593390 - DEACONESS HOSPITAL INCKYInternal Medicine Physician (207R00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 23655 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 23655 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 23655 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.

CodeComplexityDescription
23470-CPTHighArthroplas,Prox.Humeral Implnt-Neer
23620-CPTModerateClose Great Tuber Fract Wo Manip
23625-CPTModerateRed Fx-Greater Tuberosity Humerus
23655-CPTModerateClose Shoulder Dis W Manip W Anes

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23655. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 23655 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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