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See a sample rate comparisonCPT 23931 Fee Schedule
Last Verified: October 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.
Drain Arm Or Elbow Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Upper Arm Or Elbow.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23931 |
| Medicaid Fee Schedule | View Medicaid rates for 23931 |
National average reimbursement for CPT 23931 by major payers:
$341.84
$380.40
$403.60
$466.47
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CPT 23931
5 of 25 sample ratesHigher to lower in this preview
Henry Ford Medical Center Fairlane, Henry Ford Health System
Henry Ford Health System
$5,672.00Published ratePlaza Ambulatory Surgery Center LLC
$1,243.00Published rateHawthorne Surgery Center LLC
$680.00Published rateHealth & Wellness Surgery Center, Tower Surgery Center
Health Wellness Surgery Center
$555.00Published rateFlorida Specialty Surgery Center LLC
$350.00Published rate
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See a sample payer proposalCPT 23931 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23931 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 23931 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 |
|---|---|---|
| 23930-CPT | Moderate | Drain Arm Or Elbow Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Upper Arm Or Elbow. |
| 23931-CPT | Moderate | Drain Arm Or Elbow Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) From The Upper Arm Or Elbow. |
| 23935-CPT | Moderate | Inc Dp Opn B1 Crtx Hum Elbw, Incision Deep With Opening Of Bone Cortex Eg For Osteomyelitis Or Bone Abscess Humerus Or Elbow |
| 24100-CPT | Moderate | Elbow Surgery, Surgery To Explore The Elbow Joint And Remove A Sample Of Tissue For Testing (Biopsy). The Procedure May Include Removing Bone Chips Or Loose Cartilage. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23931. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23931 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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