CPT code 23525: Joint reduction, sternoclavicular with manipulation2026 Medicare rate & RVUs in Illinois
Orthopedic closed reduction of a sternoclavicular dislocation with manipulation, reported when the joint is restored without open exposure or fixation.
Medicare pays $435.32–$482.75 for 23525 in the office in Illinois, from Rest of Illinois to Chicago, IL. 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 23525 covers
Code 23525 describes closed treatment of a sternoclavicular joint dislocation in which the clinician manipulates the clavicle and sternum to restore alignment without surgically exposing the joint. An orthopedic surgeon typically performs the reduction. Posterior displacement may require urgent attention because of the sternoclavicular joint’s proximity to mediastinal structures. This code is specific to the sternoclavicular articulation, not the acromioclavicular joint or a clavicle fracture.
Report 23525 when the record supports an actual closed reduction with manipulation, rather than closed treatment without manipulation (23520) or open treatment. Document the dislocation, side, reduction maneuver, and post-reduction alignment. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%; bilateral reporting with modifier 50 is paid at 150%. An assistant is payable only with documentation of 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 23525 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$435.32 to $482.75
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $482.75 | $403.20 |
| East St. Louis, IL | $449.29 | $376.46 |
| Rest of Illinois | $435.32 | $363.04 |
| Suburban Chicago, IL | $475.47 | $394.17 |
How the 23525 rate is calculated
Each of 23525’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 · 23525
RVUs × geographic indexes × conversion factor
Work3.70
3.70 RVUs× 1.000 GPCI
Practice expense8.87
8.87 RVUs× 1.000 GPCI
Malpractice0.79
0.79 RVUs× 1.000 GPCI
Adjusted RVUs
13.3600
Conversion factor
$33.4009
Medicare rate
$446.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23525
23525 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23525
Joint reduction, sternoclavicular 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) | 0 | Not paid without supporting documentation. |
| 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 · 23525
Joint reduction, sternoclavicular 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
23525 without 50 · national office
$446.24
Joint reduction, sternoclavicular with manipulation
23525-50 · Bilateral: 150%
$669.36
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).
23525 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 23520Sternoclavicular treatmentWithout manipulation
- Both codes describe closed treatment of a sternoclavicular dislocation. Choose 23525 when manipulation is performed; 23520 is for treatment without manipulation.
- 23530Joint dislocation surgerySternoclavicular, without graft
- 23530 is for open treatment of a sternoclavicular dislocation. Use 23525 when the reduction is performed closed, without open exposure.
- 23532Joint reconstructionFascial graft
- 23532 describes open sternoclavicular dislocation treatment with a graft. It does not describe a closed reduction with manipulation.
- 23545AC joint treatmentClosed, with manipulation
- 23545 is closed treatment with manipulation of an acromioclavicular dislocation. Code 23525 applies to the sternoclavicular joint.
23525 billing questions
When should 23525 be chosen over 23520?
Use 23525 when the clinician manipulates the dislocated sternoclavicular joint to restore alignment. Use 23520 for closed treatment without manipulation.
How does 23525 differ from 23530?
23525 describes closed treatment with manipulation. 23530 describes open treatment of a sternoclavicular dislocation.
Is manipulation separately reported?
The manipulation is part of the closed treatment represented by 23525; it is not separately reported as another reduction service for the same dislocation.
What documentation supports 23525?
Document the sternoclavicular dislocation, the affected side, the closed manipulation performed, and the resulting alignment. The record should make clear that the joint was treated by manipulation rather than open exposure.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. CMS also applies the standard multiple-procedure reduction 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
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