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See a sample rate comparisonCPT 23680 Fee Schedule
Last Verified: September 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.
Surgery For Broken Shoulder, Surgery To Repair A Dislocated Shoulder Bone In Which Part Of The Upper Arm Bone Has Been Broken. The Procedure May Involve The Use Of Pins Wires Or Screws To Hold The Bones In Place.
| 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 |
| Medicaid Fee Schedule | View Medicaid rates for 23680 |
National average reimbursement for CPT 23680 by major payers:
$1,254.31
$1,228.36
$1,265.00
$1,498.85
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CPT 23680
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Pinecroft, LLC
Memorial Hermann Surgery Center Pinecroft LLC
$9,182.00Published rateThe Retina Surgery Center LLC, The Retina Surgery Center
$5,257.00Published rateJoint Replacement Center Of Louisiana
Joint Replacement Center Of Lous
$2,902.00Published rateAffiliated Physicians & Surgeons, Ltd
Affiliated Physicians Surgeons Ltd
$2,229.00Published rateAustin Miller
Deaconess Hospital Inc
$742.90Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 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 | Surgery For Broken Shoulder, Surgery To Repair A Dislocated Shoulder Bone In Which Part Of The Upper Arm Bone Has Been Broken. The Procedure May Involve The Use Of Pins Wires Or Screws To Hold The Bones In Place. |
| 23675-CPT | Moderate | Closed Treatment Of Shoulder D, Closed Treatment Of Shoulder Dislocation With Surgical Oranatomical Neck Fracture With Manipulation Closed Treatment Of Shoulder Dislocation With Surgical Or |
| 23680-CPT | High | Surgery For Broken Shoulder, Surgery To Repair A Dislocated Shoulder Bone In Which Part Of The Upper Arm Bone Has Been Broken. The Procedure May Involve The Use Of Pins Wires Or Screws To Hold The Bones In Place. |
| 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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