CPT code 23505: Clavicle fracture, with manipulation2026 Medicare rate & RVUs in Missouri
Reports closed treatment of a clavicle fracture when the physician manipulates the fracture to improve alignment without surgically exposing or fixing it.
Medicare pays $372.63–$396.54 for 23505 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 23505 covers
A physician, commonly an orthopedist, treats a clavicle fracture by manipulating the bone fragments to improve their alignment without surgically exposing the fracture or placing internal fixation. The service may be provided in a clinic, emergency department, or hospital. A sling or other immobilization may support the treated fracture; the key distinction from treatment without manipulation is that the physician actually performs a reduction maneuver, not simply that the fracture is displaced.
Select this code when the documented treatment includes manipulation of the clavicle fracture. The record should identify the fracture and side, describe the reduction maneuver and resulting alignment, and support the treatment provided. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 23505 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$372.63 to $396.54
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $392.52 | $332.93 |
| Metropolitan St. Louis, MO | $396.54 | $336.12 |
| Rest of Missouri | $372.63 | $317.93 |
How the 23505 rate is calculated
Each of 23505’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 23505
RVUs × geographic indexes × conversion factor
Work3.73
3.73 RVUs× 1.000 GPCI
Practice expense7.70
7.70 RVUs× 1.000 GPCI
Malpractice0.81
0.81 RVUs× 1.000 GPCI
Adjusted RVUs
12.2400
Conversion factor
$33.4009
Medicare rate
$408.83
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23505
23505 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23505
Clavicle fracture, with manipulation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 23505
Clavicle fracture, with manipulation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
23505 without 50 · national office
$408.83
Clavicle fracture, with manipulation
23505-50 · Bilateral: 150%
$613.25
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
23505 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23500Clavicle fracture careWithout manipulation
- Both codes describe closed clavicle fracture treatment. Choose 23505 only when the physician performs manipulation; treatment without manipulation is reported with 23500.
- 23515Clavicle fracture repairOpen treatment
- Use 23515 for open treatment with internal fixation. This code describes manipulation without surgically exposing and fixing the fracture.
- 23545AC joint treatmentClosed, with manipulation
- This code concerns closed treatment with manipulation of an acromioclavicular dislocation, not a clavicle fracture.
23505 billing questions
When should this code be chosen instead of 23500?
Use 23505 when the physician manipulates the fracture to improve alignment. Use 23500 when the clavicle fracture is treated without manipulation.
Does displacement alone support reporting this code?
No. The documentation should show that the physician performed a manipulation or reduction, rather than relying on displacement as evidence of the service.
Is routine fracture follow-up included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported?
CMS identifies this as a bilateral procedure; reporting modifier 50 results in payment at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this code. CMS does not permit co-surgeons or team surgery.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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