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CPT code 23505: Clavicle fracture, with manipulation2026 Medicare rate & RVUs in Virginia

Reports closed treatment of a clavicle fracture when the physician manipulates the fracture to improve alignment without surgically exposing or fixing it.

CMS RVU26DEffective Oct 1, 2026One payment locality124 Medicare services in 2024

In Virginia, Medicare pays $396.50 for 23505 in the office and $334.12 when it’s performed in a hospital or facility.

$396.50Office (non-facility)
$334.12Hospital or facility
−3.0%vs the national office rate ($408.83)

Check a contract rate as a % of Medicare · 23505 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 23505 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 23505 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Virginia compares for 23505

Across 109 of 109 payment localities, the office rate for 23505 runs from $359.44 in Arkansas to $523.65 in San Benito County, CA. Virginia pays $396.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

23505 in Virginia vs other payment areas
  1. Virginia · this page$396.50
  2. Los Angeles, CA · California$451.91+$55.41
  3. Washington, DC area · District of Columbia$464.39+$67.89
  4. Miami, FL · Florida$460.74+$64.24
  5. Chicago, IL · Illinois$446.02+$49.52
  6. Manhattan, NY · New York$474.32+$77.82
  7. Alaska · Alaska$475.69+$79.19

Other areas in Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

23505 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$364.94$309.41
ArkansasArkansas$359.44$304.93
ArizonaArizona$396.96$335.46
Bakersfield, CACalifornia$425.31$355.75
Chico, CACalifornia$423.08$353.53
El Centro, CACalifornia$423.22$353.66
Fresno, CACalifornia$423.08$353.53
Hanford, CACalifornia$423.08$353.53

23505 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$359.44

$475.69

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
23505 office rate range by state
State / territoryOffice rate rangeLocalities
AK$475.691
AL$364.941
AR$359.441
AZ$396.961
CA$423.08–$523.6529
CO$420.861
CT$436.801
DC$464.391
DE$403.631
FL$411.12–$460.743
GA$386.25–$418.752
GU$432.671
HI$432.671
IA$370.651
ID$373.991
IL$401.68–$446.024
IN$376.151
KS$370.721
KY$377.981
LA$378.11–$397.332
MA$418.96–$460.852
MD$410.94–$464.393
ME$378.03–$396.532
MI$389.94–$418.392
MN$397.241
MO$372.63–$396.543
MS$366.021
MT$408.771
NC$381.831
ND$392.761
NE$372.201
NH$415.991
NJ$440.10–$459.672
NM$392.921
NV$404.571
NY$387.93–$488.595
OH$386.671
OK$375.271
OR$399.76–$432.442
PA$386.25–$426.842
PR$411.251
RI$416.761
SC$385.221
SD$390.861
TN$372.901
TX$383.76–$420.918
UT$390.641
VA$396.50–$464.392
VI$411.251
VT$392.891
WA$417.61–$468.492
WI$379.301
WV$386.801
WY$401.791

See 23505 in every payment locality

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

Office or facility?

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.

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,219

Code
23505
Physician work
3.73
Practice expense
7.70
Malpractice
0.81

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 23505 in Virginia
ComponentRVULocality factorAdjusted
Physician work3.73× 1.0003.7300
Practice expense7.70× 0.9837.5691
Malpractice0.81× 0.7060.5719
Total RVUs11.8710
Conversion factor× 33.4009

Office rate, Virginia$396.50

Office: (3.73 × 1 + 7.7 × 0.983 + 0.81 × 0.706) × $33.4009 = $396.50

Facility: (3.73 × 1 + 5.8 × 0.983 + 0.81 × 0.706) × $33.4009 = $334.12

Open 23505 in the RVU calculator

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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).

When to use modifier 50

Codes related to 23505

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 23505
CodeHow it relatesOffice range, Virginia
Same family
23500Clavicle fracture care, without manipulationClavicle fracture treatment in the same family, but without manipulation.$250.86
Used instead
23515Clavicle fracture repair, open treatmentOpen treatment with internal fixation when operative exposure and fixation are performed.No office rate
Often billed with
73000Clavicle X-ray, at least two viewsClavicle radiography may be reported separately when performed and documented for the encounter.$32.74

How 23505 has changed in Virginia

23505 · Office / nonfacility

$396.50

Effective 2026-10-01

The base rate is $37.91 higher than on 2025-10-01, moving from $358.59 to $396.50 (10.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $358.59changed to$396.50

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.83 changed to 3.73
    • Practice expense RVU 6.76 changed to 7.70
    • Malpractice RVU 0.79 changed to 0.81
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $364.59changed to$358.59

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.64 changed to 6.76
    • Malpractice RVU 0.77 changed to 0.79

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $358.64changed to$364.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $367.17changed to$358.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.45 changed to 6.64
    • Malpractice RVU 0.75 changed to 0.77
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $370.96changed to$367.17

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.23 changed to 6.45
    • Malpractice RVU 0.77 changed to 0.75
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $367.20changed to$370.96

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.06 changed to 6.23
    • Malpractice RVU 0.74 changed to 0.77

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $365.78changed to$367.20

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.67 changed to 6.06
    • Malpractice RVU 0.76 changed to 0.74
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $360.61changed to$365.78

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.61 changed to 5.67
    • Malpractice RVU 0.71 changed to 0.76
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $358.41changed to$360.61

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.55 changed to 5.61
    • Malpractice RVU 0.72 changed to 0.71

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $351.83changed to$358.41

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.44 changed to 5.55
    • Malpractice RVU 0.71 changed to 0.72
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $352.60changed to$351.83

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.51 changed to 5.44
    • Malpractice RVU 0.73 changed to 0.71
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $353.81changed to$352.60

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.50 changed to 5.51
    • Malpractice RVU 0.74 changed to 0.73

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $352.05changed to$353.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $348.11changed to$352.05

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.46 changed to 5.50
    • Malpractice RVU 0.69 changed to 0.74
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $348.32changed to$348.11

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.02 changed to 5.46
    • Malpractice RVU 0.72 changed to 0.69
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $348.32

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$396.50$334.12RVU26D
2026-07-01$396.50$334.12RVU26C
2026-04-01$396.50$334.12RVU26B
2026-01-01$396.50$334.12RVU26A
2025-10-01$358.59$332.49RVU25D
2025-07-01$358.59$332.49RVU25C
2025-04-01$358.59$332.49RVU25B
2025-01-01$358.59$332.49RVU25A
2024-10-01$364.59$338.06RVU24D
2024-07-01$364.59$338.06RVU24C
2024-04-01$364.59$338.06RVU24B
2024-03-09$364.59$338.06RVU24AR
2024-01-01$358.64$332.54RVU24A
2023-10-01$367.17$340.33RVU23D
2023-07-01$367.17$340.33RVU23C
2023-04-01$367.17$340.33RVU23B
2023-01-01$367.17$340.33RVU23A
2022-10-01$370.96$344.45RVU22D
2022-07-01$370.96$344.45RVU22C
2022-04-01$370.96$344.45RVU22B
2022-01-01$370.96$344.45RVU22A
2021-10-01$367.20$341.51RVU21D
2021-07-01$367.20$341.51RVU21C
2021-04-01$367.20$341.51RVU21B
2021-01-01$367.20$341.51RVU21A
2020-10-01$365.78$342.53RVU20D
2020-07-01$365.78$342.53RVU20C
2020-04-01$365.78$342.53RVU20B
2020-01-01$365.78$342.53RVU20A
2019-10-01$360.61$337.87RVU19D
2019-07-01$360.61$337.87RVU19C
2019-04-01$360.61$337.87RVU19B
2019-01-01$360.61$337.87RVU19A
2018-10-01$358.41$336.76RVU18D
2018-07-01$358.41$336.76RVU18C
2018-04-01$358.41$336.76RVU18B
2018-01-01$358.41$336.76RVU18AR1
2017-10-01$351.83$332.38RVU17D
2017-07-01$351.83$332.38RVU17C
2017-04-01$351.83$332.38RVU17B
2017-01-01$351.83$332.38RVU17A
2016-10-01$352.60$333.24RVU16D
2016-07-01$352.60$333.24RVU16C
2016-04-01$352.60$333.24RVU16B
2016-01-01$352.60$333.24RVU16A
2015-10-01$353.81$333.68RVU15D
2015-07-01$353.81$333.68RVU15C
2015-04-01$352.05$332.02RVU15B
2015-01-01$352.05$332.02RVU15A
2014-10-01$348.11$329.15RVU14D
2014-07-01$348.11$329.15RVU14C
2014-04-01$348.11$329.15RVU14B
2014-01-01$348.11$329.15RVU14A
2013-10-01$348.32$328.05RVU13D
2013-07-01$348.32$328.05RVU13C
2013-04-01$348.32$328.05RVU13B
2013-01-01$348.32$328.05RVU13AR

Price 23505 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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
RVUs for 23505PPRRVU2026_Oct_nonQPP.csv, line 2,219 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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