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CPT code 23520: Sternoclavicular treatment, without manipulation2026 Medicare rate & RVUs in King County, WA

Reports closed care of a sternoclavicular joint dislocation when the provider treats the injury without manipulating the joint to reduce it.

CMS RVU26DEffective Oct 1, 2026One payment locality11 Medicare services in 2024

In King County, WA, Medicare pays $312.34 for 23520 in the office and $282.83 when it’s performed in a hospital or facility.

$312.34Office (non-facility)
$282.83Hospital or facility
+15.4%vs the national office rate ($270.55)

Check a contract rate as a % of Medicare · 23520 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 23520 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in King County, WA
  2. What 23520 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 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.

How King County, WA compares for 23520

Across 109 of 109 payment localities, the office rate for 23520 runs from $237.50 in Arkansas to $351.18 in San Benito County, CA. King County, WA pays $312.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

23520 in King County, WA vs other payment areas
  1. King County, WA · this page$312.34
  2. Rest of Washington · Washington$277.32−$35.02
  3. Los Angeles, CA · California$301.33−$11.01
  4. Washington, DC area · District of Columbia$308.45−$3.89
  5. Miami, FL · Florida$301.95−$10.39
  6. Chicago, IL · Illinois$292.30−$20.04
  7. Manhattan, NY · New York$313.73+$1.39

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

Every other payment area

23520 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$312.46$286.85
AlabamaAlabama$241.19$220.15
ArkansasArkansas$237.50$216.84
ArizonaArizona$262.70$239.39
Bakersfield, CACalifornia$283.14$256.78
Chico, CACalifornia$281.84$255.49
El Centro, CACalifornia$281.92$255.57
Fresno, CACalifornia$281.84$255.49

23520 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.

$237.50

$316.51

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

View every state and territory as a table
23520 office rate range by state
State / territoryOffice rate rangeLocalities
AK$312.461
AL$241.191
AR$237.501
AZ$262.701
CA$281.84–$351.1829
CO$279.551
CT$289.221
DC$308.451
DE$267.171
FL$270.51–$301.953
GA$254.08–$276.812
GU$288.651
HI$288.651
IA$245.751
ID$247.851
IL$263.69–$292.304
IN$249.311
KS$245.451
KY$249.191
LA$249.15–$262.042
MA$278.11–$306.872
MD$272.17–$308.453
ME$250.18–$263.132
MI$256.88–$275.002
MN$264.731
MO$245.25–$261.923
MS$241.381
MT$270.521
NC$252.801
ND$261.221
NE$246.891
NH$275.981
NJ$291.64–$305.172
NM$258.731
NV$268.111
NY$256.87–$322.865
OH$254.981
OK$247.751
OR$265.16–$287.742
PA$254.89–$282.312
PR$272.301
RI$276.221
SC$254.481
SD$260.121
TN$246.871
TX$253.20–$279.378
UT$258.121
VA$262.87–$308.452
VI$272.301
VT$260.991
WA$277.32–$312.342
WI$252.111
WV$253.691
WY$266.471

See 23520 in every payment locality

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.

How the rate is built · 23520

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.23

2.23 RVUs× 1.000 GPCI

Practice expense5.40

5.40 RVUs× 1.000 GPCI

Malpractice0.47

0.47 RVUs× 1.000 GPCI

Adjusted RVUs

8.1000

Conversion factor

$33.4009

Medicare rate

$270.55

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact King County, WA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,221

Code
23520
Physician work
2.23
Practice expense
5.40
Malpractice
0.47

GPCI2026.csv

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 23520 in King County, WA
ComponentRVULocality factorAdjusted
Physician work2.23× 1.0502.3415
Practice expense5.40× 1.2276.6258
Malpractice0.47× 0.8170.3840
Total RVUs9.3513
Conversion factor× 33.4009

Office rate, King County, WA$312.34

Office: (2.23 × 1.05 + 5.4 × 1.227 + 0.47 × 0.817) × $33.4009 = $312.34

Facility: (2.23 × 1.05 + 4.68 × 1.227 + 0.47 × 0.817) × $33.4009 = $282.83

Open 23520 in the RVU calculator

Payment rules and modifiers for 23520

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

CMS payment indicators · 23520

Sternoclavicular treatment, without 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)0Not paid without supporting documentation.
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 · 23520

Sternoclavicular treatment, without 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

23520 without 50 · national office

$270.55

Sternoclavicular treatment, without manipulation

23520-50 · Bilateral: 150%

$405.83

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 23520

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

Codes related to 23520
CodeHow it relatesOffice range, King County, WA
Same family
23525Joint reduction, sternoclavicular with manipulationClosed treatment of a sternoclavicular dislocation when manipulation is performed.$514.84
Used instead
23530Joint dislocation surgery, sternoclavicular, without graftOpen treatment of a sternoclavicular dislocation.No office rate
23532Joint reconstruction, fascial graftOpen sternoclavicular dislocation treatment with graft.No office rate

How 23520 has changed in King County, WA

23520 · Office / nonfacility

$312.34

Effective 2026-10-01

The base rate is $28.59 higher than on 2025-10-01, moving from $283.75 to $312.34 (10.1%).

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

    $283.75changed to$312.34

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.29 changed to 2.23
    • Practice expense RVU 4.89 changed to 5.40
    • Malpractice RVU 0.49 changed to 0.47
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $287.78changed to$283.75

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.80 changed to 4.89
    • Malpractice RVU 0.47 changed to 0.49

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $283.09changed to$287.78

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $284.61changed to$283.09

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.69 changed to 4.80
    • Malpractice RVU 0.44 changed to 0.47
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $280.54changed to$284.61

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.51 changed to 4.69
    • Malpractice RVU 0.45 changed to 0.44
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $278.28changed to$280.54

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.40 changed to 4.51

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $270.40changed to$278.28

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.05 changed to 4.40
    • Malpractice RVU 0.46 changed to 0.45
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $264.16changed to$270.40

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.97 changed to 4.05
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $261.31changed to$264.16

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.90 changed to 3.97
    • Malpractice RVU 0.47 changed to 0.46

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $251.57changed to$261.31

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.77 changed to 3.90
    • Malpractice RVU 0.45 changed to 0.47
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $243.20changed to$251.57

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.66 changed to 3.77
    • Malpractice RVU 0.44 changed to 0.45
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $252.25changed to$243.20

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.84 changed to 3.66
    • Malpractice RVU 0.48 changed to 0.44

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $251.00changed to$252.25

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $250.98changed to$251.00

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.80 changed to 3.84
    • Malpractice RVU 0.42 changed to 0.48
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $256.13changed to$250.98

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.19 changed to 3.80
    • Malpractice RVU 0.44 changed to 0.42
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $256.13

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$312.34$282.83RVU26D
2026-07-01$312.34$282.83RVU26C
2026-04-01$312.34$282.83RVU26B
2026-01-01$312.34$282.83RVU26A
2025-10-01$283.75$281.78RVU25D
2025-07-01$283.75$281.78RVU25C
2025-04-01$283.75$281.78RVU25B
2025-01-01$283.75$281.78RVU25A
2024-10-01$287.78$285.35RVU24D
2024-07-01$287.78$285.35RVU24C
2024-04-01$287.78$285.35RVU24B
2024-03-09$287.78$285.35RVU24AR
2024-01-01$283.09$280.69RVU24A
2023-10-01$284.61$281.34RVU23D
2023-07-01$284.61$281.34RVU23C
2023-04-01$284.61$281.34RVU23B
2023-01-01$284.61$281.34RVU23A
2022-10-01$280.54$276.41RVU22D
2022-07-01$280.54$276.41RVU22C
2022-04-01$280.54$276.41RVU22B
2022-01-01$280.54$276.41RVU22A
2021-10-01$278.28$274.95RVU21D
2021-07-01$278.28$274.95RVU21C
2021-04-01$278.28$274.95RVU21B
2021-01-01$278.28$274.95RVU21A
2020-10-01$270.40$269.13RVU20D
2020-07-01$270.40$269.13RVU20C
2020-04-01$270.40$269.13RVU20B
2020-01-01$270.40$269.13RVU20A
2019-10-01$264.16$264.57RVU19D
2019-07-01$264.16$264.57RVU19C
2019-04-01$264.16$264.57RVU19B
2019-01-01$264.16$264.57RVU19A
2018-10-01$261.31$264.20RVU18D
2018-07-01$261.31$264.20RVU18C
2018-04-01$261.31$264.20RVU18B
2018-01-01$261.31$264.20RVU18AR1
2017-10-01$251.57$255.70RVU17D
2017-07-01$251.57$255.70RVU17C
2017-04-01$251.57$255.70RVU17B
2017-01-01$251.57$255.70RVU17A
2016-10-01$243.20$247.33RVU16D
2016-07-01$243.20$247.33RVU16C
2016-04-01$243.20$247.33RVU16B
2016-01-01$243.20$247.33RVU16A
2015-10-01$252.25$255.99RVU15D
2015-07-01$252.25$255.99RVU15C
2015-04-01$251.00$254.72RVU15B
2015-01-01$251.00$254.72RVU15A
2014-10-01$250.98$255.10RVU14D
2014-07-01$250.98$255.10RVU14C
2014-04-01$250.98$255.10RVU14B
2014-01-01$250.98$255.10RVU14A
2013-10-01$256.13$260.80RVU13D
2013-07-01$256.13$260.80RVU13C
2013-04-01$256.13$260.80RVU13B
2013-01-01$256.13$260.80RVU13AR

Price 23520 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 23520 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

23520 billing questions

When should 23520 be chosen instead of 23525?

Report 23520 when the sternoclavicular dislocation is treated closed without manipulation. Choose 23525 when the provider manipulates the joint as part of closed treatment.

How does 23520 differ from open treatment?

23520 describes closed treatment without manipulation. When the provider surgically treats the sternoclavicular dislocation, consider the applicable open-treatment code, such as 23530 or 23532.

What documentation supports reporting 23520?

Document the sternoclavicular joint dislocation, the closed treatment plan, and that the joint was not manipulated. Include the treatment provided, such as immobilization or activity restrictions, when applicable.

What is included in the global period?

CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral treatment reported?

For bilateral treatment, CMS pays modifier 50 at 150%. The code's multiple-procedure reduction also applies when other procedures are performed in the same session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.

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 23520PPRRVU2026_Oct_nonQPP.csv, line 2,221 (RVU26D)
Geographic factors for King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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