CPT 23655 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 | • 23 - Emergency Room • 21 - Inpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23655 |
National average reimbursement for CPT 23655 by major payers:

$549.48

$530.26

$564.99

$679.16
| 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 23655 | ||||||
United | 23655 | $438.00 | 1487627642 - SURGERY CENTER OF CORAL GABLES LLC, SURGERY CENTER OF CORAL GABLES LLC | 621827649 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $915.00 | 1366154304 - OPTUM CARE WASHINGTON PLLC, OPTUM - HELEN HOLM PUMPHREY SURGERY CENTER | 910214500 - THE EVERETT CLINIC, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $701.84 | 1346774536 - AYSHA KHAN | 350593390 - DEACONESS HOSPITAL INC | IL | Internal Medicine Physician (207R00000X) |
United | 23655 | $1525.00 | 1396896684 - DREYER AMBULATORY SURGERY CENTER, LLC | 363890298 - (IL) DREYER AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $980.00 | 1295906956 - THE ENT CENTER OF RHODE ISLAND LLC, THE SURGERY CENTER OF RHODE ISLAND | 260329297 - (RI) THE ENT CENTER OF RHODE ISLAND | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $750.00 | 1033525779 - US CARDIO OF SA, LLC | 465144655 - (TX) US CARDIO OF SA LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $485.00 | 1811059306 - PENINSULA EYE CENTER, P.A, PENINSULA CATARACT & LASER CENTER | 520974706 - (MD) PENINSULA EYE CENTER PA | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $600.00 | 1770528838 - BREVARD SURGERY CENTER | 593128478 - (FL) BREVARD SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $2782.00 | 1699738112 - NORTH AUSTIN SURGERY CENTER, L.P. | 200648730 - (TX) NORTH AUSTIN SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $810.00 | 1689633588 - SOUTH JERSEY ENDOSCOPY LLC, DIMARINO-KROOP-PRIETO GI ASSOC | 200478348 - (NJ) SOUTH JERSEY ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $732.00 | 1619998523 - UPSTATE SURGERY CENTER, LLC | 562186977 - (SC) UPSTATE SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $770.00 | 1982975959 - ARCHIBALD SURGERY CENTER, LLC | 453730425 - (CA) ARCHIBALD SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $700.00 | 1598144909 - TRINITY AMBULATORY SURGICAL CENTER LLC, HEART & RHYTHM INSTITUTE OF TRINITY | 472090172 - (FL) TRINITY AMBULATORY SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $606.00 | 1497314181 - OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS, LLC | 832118109 - (IL) OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23655 | $701.84 | 1730412826 - RAMIN RASHIDIAN | 350593390 - DEACONESS HOSPITAL INC | KY | Internal Medicine Physician (207R00000X) |
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 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.
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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