How much does Medicare pay for CPT 23120?

Medicare allowed an average of $351.83 per service and paid $279.74 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3611.76, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 23120?

Partial removal of collar bone. It was billed 1,247 times to 1,228 Medicare beneficiaries by 67 providers in 2024.

Which specialty bills 23120 most?

Orthopedic Surgery, with 699 services from 36 clinicians. Next are Ambulatory Surgical Center, Physician Assistant, Nurse Practitioner.

CPT 23120

Partial removal of collar bone

$351.83Medicare-allowed amount per service, averaged across 1,247 services

Providers submitted

$3611.76

Asking price, not received

Medicare allowed

$351.83

The fee schedule figure

Medicare paid

$279.74

Balance is patient coinsurance

Providers submitted an average of $3611.76 for this code and Medicare allowed $351.83 — 10.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $279.74 (80%); the rest is the patient’s coinsurance and deductible.

Services: 1,247
Beneficiaries: 1,228
Providers billing it: 67
Total allowed: $438,732

What Medicare pays for CPT 23120

Across 1,247 services billed by 67 providers to 1,228 beneficiaries, Medicare allowed an average of $351.83 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 23120

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	699	685	$297.28	36
Ambulatory Surgical Center	287	283	$728.48	17
Physician Assistant	173	172	$39.38	9
Nurse Practitioner	43	43	$43.30	3
Sports Medicine	34	34	$285.47	1
Hand Surgery	11	11	$316.33	1

23120 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	171	$463.95	$374.23	7
Pennsylvania	97	$375.31	$319.13	5
Texas	81	$190.21	$153.91	5
Missouri	74	$445.30	$381.66	4
Utah	74	$298.07	$246.62	4
Arizona	73	$345.23	$278.48	3
New Jersey	72	$179.67	$135.74	2
Washington	66	$619.81	$496.92	5
Georgia	63	$406.50	$357.90	3
Wyoming	61	$230.81	$191.18	2
South Dakota	39	$197.10	$172.80	2
Kansas	38	$495.53	$414.71	2
Tennessee	37	$420.46	$380.60	2
Arkansas	31	$134.42	$143.61	2
Hawaii	27	$298.66	$235.17	1
California	27	$307.80	$231.75	2
Alaska	26	$538.96	$428.25	2
Wisconsin	25	$158.90	$137.29	2
Mississippi	22	$449.96	$414.26	2
Louisiana	20	$256.36	$234.49	1
Virginia	18	$291.87	$230.19	1
Kentucky	16	$281.47	$234.64	1
Colorado	14	$283.78	$233.78	1
New York	14	$342.57	$234.05	1
Indiana	14	$259.93	$258.53	1
Ohio	13	$299.58	$227.21	1
Oklahoma	12	$480.41	$434.15	1
Nebraska	11	$264.83	$234.52	1
Connecticut	11	$316.33	$234.52	1

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.