CPT 23680 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 23680 |
National average reimbursement for CPT 23680 by major payers:
$1,254.31
$1,228.36
$1,265.00
$1,540.39
| 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 23680 | ||||||
United | 23680 | $6087.00 | 1598083594 - MID-STATE ENDOSCOPY CENTER LLC | 270673692 - (TN) MIDSTATE ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $5797.00 | 1396919783 - SURGCENTER OF SOUTHERN MARYLAND, LLC | 261572885 - (MD) SURGCENTER OF SOUTHERN MARYLAND | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $1074.00 | 1023498219 - GREAT LAKES AMBULATORY SURGERY CENTER | 352512220 - (OH) GREAT LAKES AMBULATORY SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $5257.00 | 1457670648 - THE RETINA SURGERY CENTER LLC, THE RETINA SURGERY CENTER | 853784941 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $742.90 | 1386920551 - JESSICA FOUTS | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 23680 | $2746.00 | 1205869211 - ROANOKE SURGERY CENTER, LP | 61755240 - (VA) ROANOKE SURGERY CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $2412.00 | 1134300080 - METAIRIE LA ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER-METAIRIE | 205904604 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $4638.87 | 1285340430 - CORRIDOR SURGERY CENTER | 832869527 - (IA) CORRIDOR SURGERY CENTER | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $2526.00 | 1457077174 - BATTLE STREET SURGERY CENTER, LLC | 920682808 - (AR) BATTLE STREET SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $2800.00 | 1487169769 - ELKRIDGE ASC LLC | 475585574 - (MD) ELKRIDGE ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $7888.00 | 1730713439 - FLORIDA SPRINGS SURGERY CENTER LLC | 832895293 - (FL) FLORIDA SPRINGS SURGERY CENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $2600.00 | 1093723900 - CARTER REAL ESTATE PROPERTIES INC, NORTH DALLAS SURGICARE | 752521630 - (TX) CARTER REAL ESTATE PROPERTIES INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $4636.00 | 1508965401 - MILLENNIUM SURGERY CENTER INC | 770513445 - (CA) MILLENNIUM SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $4170.00 | 1982680492 - ROCKLAND SURGICAL PROJECT, LLC, RAMAPO VALLEY SURGICAL CENTER | 200580403 - (NJ) ROCKLAND SURGICAL PROJECT LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23680 | $970.00 | 1659903292 - RACINE DIGESTIVE HEALTH CENTER LLC | 844211105 - (WI) RACINE DIGESTIVE HEALTH CENTER LLC | WI | 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 23680 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23680 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 23680 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 |
|---|---|---|
| 23670-CPT | High | Open Treatment Of Shoulder Dislocation, With Fracture Of Greater Humeral Tuberosity, Includes Internal Fixation, When Performed |
| 23675-CPT | Moderate | Red Disloc-Shoulder W Neck Fx |
| 23680-CPT | High | Open Treatment Of Shoulder Dislocation, With Surgical Or Anatomical Neck Fracture, Includes Internal Fixation, When Performed |
| 23700-CPT | Moderate | Manipulation Under Anesthesia, Shoulder Joint, Including Application Of Fixation Apparatus- Rn Review: Medicaid 5/14/11-9/9/21, Commercial 7/5/11-9/9/21 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23680. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23680 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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