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CPT 23935 Fee Schedule

Last Verified: December 2025

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.

Incis,Deep,Op.Cortex-Humerus/Elbow
Key FactDetail
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 LevelModerate

National average reimbursement for CPT 23935 by major payers:

bcbs

$684.85

uhc

$687.73

aetna

$689.45

cigna

$867.78

Preview provider-level rates for...
For billing codeCPT 23935
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 23935

United
23935$2388.001003813221 - UNIVERSITY SURGERY CENTER LTD742894406 - (FL) UNIVERSITY SURGERY CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$2121.001710945787 - UPLAND OUTPATIENT SURGERY CENTER LP, ONTARIO ADVANCED SURGERY CENTER330812827 - (CA) UPLAND OUTPATIENT SURGERY CENTER LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$1282.001174607303 - SOUTHWEST MEDICAL ASSOCIATES INC., SOUTHWEST SURGICAL CENTER880201420NVAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$1387.001821167479 - EVERGREEN EYE CENTER, PLLC, EVERGREEN EYE SURGERY CENTER911628032 - (WA) EVERGREEN EYE CENTER, INC. P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$951.001578881009 - EYE LASER AND SURGERY CENTER LLC272376757 - (OH) EYE LASER AND SURGERY CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$7081.001174969372 - AURORA GI ASC LLC, WISCONSIN DIGESTIVE HEALTH CENTER461848055 - (WI) AURORA GI ASC LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$1151.001619998523 - UPSTATE SURGERY CENTER, LLC562186977 - (SC) UPSTATE SURGERY CENTER LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$1002.001598879512 - NORTHLAND EYE SURGERY CENTER, LLC203685944MOAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$944.881184897472 - LAKE COUNTRY ENDOSCOPY CENTER, LLC261572986 - (WI) LAKE COUNTRY ENDOSCOPY CENTER LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$1176.001831484567 - GRIFFISS EC, LLC, GRIFFISS EYE SURGERY CENTER263738675 - (NY) GRIFFISS EC LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$3495.001902319478 - CARRIS HEALTH LLC, CENTRACARE WILLMAR SURGERY CENTER823166379 - (MN) CARRIS HEALTH LLCMNAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$1964.001386721249 - ALLIED PHYSICIANS SURGERY CENTER, LLC352057452 - (IN) ALLIED PHYSICIANS SURGERY CENTER LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$2119.001083912745 - RED ROCKS SURGERY CENTERS, LLC271095323 - (CO) RED ROCKS SURGERY CENTERS LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$1050.001033560420 - ABINGDON SURGICAL CENTER PC813054896 - (MD) ABINGDON SURGICAL CENTER PCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
23935$3930.001770566192 - SUMMERLIN BEND SURGERY CENTER LLP, ADULT & CHILDRENS SURGERY CENTER OF SOUTHWEST FLORIDA651005912 - (FL) SUMMERLIN BEND SURGERY CENTERFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 23935 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 23935 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 23935 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.

CodeComplexityDescription
23930-CPTModerateI&D Up-Arm/Elbow;Deep Absc/Hematoma
23931-CPTModerateI&D Infected Bursa Humerus/Elbow
23935-CPTModerateIncis,Deep,Op.Cortex-Humerus/Elbow
24100-CPTModerateArthrotomy Elbow Synovial Bx

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23935. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 23935 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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