CPT 23935 Fee Schedule
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.
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23935 |
National average reimbursement for CPT 23935 by major payers:

$684.85

$687.73

$689.45

$867.78
| 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 23935 | ||||||
United | 23935 | $3150.00 | 1649793613 - BAYLOR SURGICARE AT BLUE STAR, LLC | 812931756 - (TX) BAYLOR SURGICARE AT BLUE STAR LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $1011.00 | 1306214705 - GSI ASC, LLC | 474883816 - (OK) GSI ASC LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $2924.00 | 1720324296 - MT OGDEN UTAH SURGICAL CENTER LLC | 371705271 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $3930.00 | 1770566192 - SUMMERLIN BEND SURGERY CENTER LLP, ADULT & CHILDRENS SURGERY CENTER OF SOUTHWEST FLORIDA | 651005912 - (FL) SUMMERLIN BEND SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $1725.00 | 1851356786 - WAUSAU SURGERY CENTER LLC | 621525773 - (WI) WAUSAU SURGERY CENTER, L.P. | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $1282.00 | 1174607303 - SOUTHWEST MEDICAL ASSOCIATES INC., SOUTHWEST SURGICAL CENTER | 880201420 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $7081.00 | 1174969372 - AURORA GI ASC LLC, WISCONSIN DIGESTIVE HEALTH CENTER | 461848055 - (WI) AURORA GI ASC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $1550.00 | 1841840758 - GULFSTREAM PARC ASC LLC | 843025864 - (TX) GULFSTREAM PARC ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $8705.00 | 1205939345 - BELTWAY SURGERY CENTERS LLC, INDIANA HAND TO SHOULDER BELTWAY SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $1479.00 | 1558672626 - CALIFORNIA COLON AND RECTAL CANCER SCREENING CENTER LLC, CALIFORNIA COLON ANDD RECTAL CANCER SCREENING CENTER LLC | 273443611 - (CA) CALIFORNIA COLON AND RECTAL CANCER SCREENING CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $1387.00 | 1821167479 - EVERGREEN EYE CENTER, PLLC, EVERGREEN EYE SURGERY CENTER | 911628032 - (WA) EVERGREEN EYE CENTER, INC. P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $1475.00 | 1164093068 - CLEAVER MEDICAL GROUP SURGERY CENTER | 843337139 - (GA) CLEAVER MEDICAL GROUP SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $697.00 | 1275639023 - SURGICAL CENTER OF BURLINGTON COUNTY, INC | 202116181 - (NJ) SURGICAL CENTER OF BURLINGTON COUNTY INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $3500.00 | 1245657840 - SURGCENTER OF PLANO LLC | 462873916 - (TX) SURGCENTER OF PLANO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 23935 | $1155.00 | 1346596566 - SCP INDIANAPOLIS LLC | 460639908 | IN | 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 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.
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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