CPT 23430

Shoulder Repair or Replacement - Open

Current code41 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for CPT 23430 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
Island HospitalAnacortes	$3,145 – $3,4133 plans	$342 – $1,710	$342 – $1,710
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	$1,385Doctor’s fee: $900 – $1,385	$2,131Doctor’s fee: $1,385 – $2,131
Three Rivers HospitalBrewster	Doctor’s fee: $550 – $1,051	Doctor’s fee: $786 – $1,502	Doctor’s fee: $786 – $1,502
Virginia Mason Medical CenterSeattle	—	$8,429	$16,528

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County): $769 in a hospital or surgery center
Doctor's fee, rest of Washington: $701 in a hospital or surgery center
Hospital outpatient payment (national): $7,413 (APC 5114)
Surgery center payment (national): $4,677

How hospitals also write this code

Some price files write it differently. These are counted as CPT 23430:

23430P (with a letter after it, P; 2 price lines)