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See a sample rate comparisonCPT 23920 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.
Disarticulation Of Shoulder
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 23920 |
| Medicaid Fee Schedule | View Medicaid rates for 23920 |
National average reimbursement for CPT 23920 by major payers:
$1,492.66
$1,501.68
$1,535.21
$1,825.71
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CPT 23920
5 of 25 sample ratesHigher to lower in this preview
Senate Street Surgery Center LLC, Clarian Health Partners Inc Mbr
Senate Street Surgery Center LLC
$10,360.00Published rateSurgery Center At University Park, LLC, Premier Surgery Center Of Sarasota
Surgery Center At University Park LLC
$6,365.00Published rateGeorgia Vascular & Vein Center
Georgia Vascular Vein Center
$3,739.00Published rateGainesville Surg Ctr Lp
$2,472.00Published rateMetropolitan Surgical Associates Inc. Dba Metropolitan Medical Assoc
Metropolitan Surgical Associates, Inc.
$700.00Published rate
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See a sample payer proposalCPT 23920 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23920 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 23920 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 |
|---|---|---|
| 23900-CPT | High | Interthoracoscapular Amputation |
| 23920-CPT | High | Disarticulation Of Shoulder |
| 23921-CPT | Moderate | Disarticulation Sho Sec Clsr, Revision Of Scar Or Wound Closure Following Removal Of Arm And Shoulder Blade At Shoulder Joint |
| 24160-CPT | High | Removal Of Prosthesis Includes Debridement And Synovectomy When Performed; Humeral And Ulnar Components (Revised 01/01/2014) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23920 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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