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

In West Virginia, Medicare pays $253.69 for 23520 in the office and $232.79 when it’s performed in a hospital or facility.

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.

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 West Virginia 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. West Virginia pays $253.69. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

23520 rates by state

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

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.

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

Codes related to 23520

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

How 23520 has changed in West Virginia

Price 23520 for an earlier date of service

Where the West Virginia rate applies

West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.

• Accoville
• Addison (Webster Springs)
• Adrian
• Albright
• Alderson
• Alum Creek
• Amherstdale
• Anawalt

Browse all communities in West Virginia

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