CPT 23395 Surgery - Musculoskeletal

How Much Does Muscle Transfer Shoulder/arm Cost?

Also known as: Muscle transfer shoulder/arm (CPT 23395)

Muscle Transfer Shoulder/arm (CPT 23395) costs $1,178 at Medicare rates. Hospital outpatient rate: $7.

Cost Comparison by Payer

How much Muscle transfer shoulder/arm costs across different settings and payers

Medicare
Facility rate
$1,178
Hospital Outpatient
OPPS rate
$7
Surgery Center
ASC rate
$3
Medicare (Facility)
$1,178
CMS PFS 2026 national rate
Hospital Outpatient
$7
OPPS rate
Surgery Center (ASC)
$3
Ambulatory surgery center

Procedures Commonly Done Together

These procedures are frequently performed alongside Muscle transfer shoulder/arm

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How to Reduce Your Cost for Muscle transfer shoulder/arm

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $3, compared to $7 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

18.08
Work RVU
13.46
Practice Expense RVU
3.72
Malpractice RVU
35.26
Total RVU

Payment = Total RVU (35.26) x CF ($33.40) = $1,178

Frequently Asked Questions

How much does Muscle transfer shoulder/arm cost?

The Medicare facility rate for Muscle transfer shoulder/arm is $1,178. In a hospital outpatient setting, the rate is $7. At an ambulatory surgery center, the rate is $3. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Muscle transfer shoulder/arm cost without insurance?

Without insurance, the cost of Muscle transfer shoulder/arm can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Muscle transfer shoulder/arm?

Most commercial health insurance plans and Medicare cover Muscle transfer shoulder/arm when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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