CPT code 23520: Sternoclavicular treatment, without manipulation2026 Medicare rate & RVUs

Medicare pays $270.55 for 23520 nationally in the office and $246.50 in a hospital or facility. Local office rates run $237.50–$351.18.

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

What 23520 covers

This code describes closed treatment of a dislocation where the clavicle meets the sternum, without manipulation of the joint. An orthopedic surgeon or other qualified treating provider may manage the injury with measures such as a sling, activity restrictions, and clinical follow-up. It applies to the sternoclavicular joint, not the acromioclavicular joint at the outer end of the clavicle. The code reflects definitive treatment, rather than simply identifying the injury during an evaluation.

Choose this code when the documented treatment is closed and no manipulation is performed; use the related with-manipulation code when the provider manipulates the joint. Documentation should identify the sternoclavicular dislocation and support the treatment approach. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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 23520 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

23520 rates by state

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

How the 23520 rate is calculated

Each of 23520’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.

Payment rules and modifiers for 23520

23520 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

23520 compared with similar codes

How to choose

23525Joint reductionSternoclavicular with manipulation

Both describe closed treatment of a sternoclavicular dislocation. Use 23520 without manipulation and 23525 when the provider manipulates the joint.

23530Joint dislocation surgerySternoclavicular, without graft

23530 is for open treatment of a sternoclavicular dislocation; 23520 is closed treatment without manipulation.

23540AC joint dislocationWithout manipulation

23540 treats a dislocation at the acromioclavicular joint, near the shoulder, rather than the sternoclavicular joint treated by 23520.

23500Clavicle fracture careWithout manipulation

23500 concerns closed treatment of a clavicular fracture. 23520 concerns a dislocation at the sternoclavicular joint.

Codes related to 23520

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

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

Open CMS sourceHow we calculate rates