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CPT code 23525: Joint reduction, sternoclavicular with manipulation2026 Medicare rate & RVUs in North Carolina

Orthopedic closed reduction of a sternoclavicular dislocation with manipulation, reported when the joint is restored without open exposure or fixation.

CMS RVU26DEffective Oct 1, 2026One payment locality

In North Carolina, Medicare pays $416.86 for 23525 in the office and $343.00 when it’s performed in a hospital or facility.

$416.86Office (non-facility)
$343.00Hospital or facility
−6.6%vs the national office rate ($446.24)

Check a contract rate as a % of Medicare · 23525 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 23525 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 23525 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 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.

How North Carolina compares for 23525

Across 109 of 109 payment localities, the office rate for 23525 runs from $391.66 in Arkansas to $578.54 in San Benito County, CA. North Carolina pays $416.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

23525 in North Carolina vs other payment areas
  1. North Carolina · this page$416.86
  2. Los Angeles, CA · California$496.65+$79.79
  3. Washington, DC area · District of Columbia$508.63+$91.77
  4. Miami, FL · Florida$498.73+$81.87
  5. Chicago, IL · Illinois$482.75+$65.89
  6. Manhattan, NY · New York$517.60+$100.74
  7. Alaska · Alaska$515.44+$98.58

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

Every other payment area

23525 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$397.75$328.49
ArkansasArkansas$391.66$323.67
ArizonaArizona$433.25$356.55
Bakersfield, CACalifornia$466.71$379.95
Chico, CACalifornia$464.54$377.78
El Centro, CACalifornia$464.67$377.91
Fresno, CACalifornia$464.54$377.78
Hanford, CACalifornia$464.54$377.78

23525 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.

$391.66

$521.54

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

View every state and territory as a table
23525 office rate range by state
State / territoryOffice rate rangeLocalities
AK$515.441
AL$397.751
AR$391.661
AZ$433.251
CA$464.54–$578.5429
CO$460.901
CT$477.061
DC$508.631
DE$440.631
FL$446.47–$498.733
GA$419.31–$456.652
GU$475.721
HI$475.721
IA$405.141
ID$408.631
IL$435.32–$482.754
IN$411.051
KS$404.711
KY$411.111
LA$411.06–$432.342
MA$458.56–$505.882
MD$448.86–$508.633
ME$412.56–$433.832
MI$423.86–$453.972
MN$436.251
MO$404.67–$432.073
MS$398.171
MT$446.181
NC$416.861
ND$430.561
NE$407.011
NH$455.081
NJ$481.00–$503.222
NM$426.951
NV$442.131
NY$423.59–$532.755
OH$420.671
OK$408.651
OR$437.21–$474.342
PA$420.49–$465.702
PR$449.101
RI$455.511
SC$419.761
SD$428.721
TN$407.061
TX$417.70–$460.668
UT$425.771
VA$433.44–$508.632
VI$449.101
VT$430.241
WA$457.24–$514.842
WI$415.531
WV$418.801
WY$439.381

See 23525 in every payment locality

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

Office or facility?

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.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,222

Code
23525
Physician work
3.70
Practice expense
8.87
Malpractice
0.79

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 23525 in North Carolina
ComponentRVULocality factorAdjusted
Physician work3.70× 1.0003.7000
Practice expense8.87× 0.9338.2757
Malpractice0.79× 0.6390.5048
Total RVUs12.4805
Conversion factor× 33.4009

Office rate, North Carolina$416.86

Office: (3.7 × 1 + 8.87 × 0.933 + 0.79 × 0.639) × $33.4009 = $416.86

Facility: (3.7 × 1 + 6.5 × 0.933 + 0.79 × 0.639) × $33.4009 = $343.00

Open 23525 in the RVU calculator

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

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 · 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.

  • 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

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).

When to use modifier 50

Codes related to 23525

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

Codes related to 23525
CodeHow it relatesOffice range, North Carolina
Same family
23520Sternoclavicular treatment, without manipulationClosed treatment of a sternoclavicular dislocation without manipulation.$252.80
Used instead
23530Joint dislocation surgery, sternoclavicular, without graftOpen treatment of a sternoclavicular dislocation instead of closed reduction.No office rate
23532Joint reconstruction, fascial graftOpen sternoclavicular dislocation treatment with graft when that operative method is performed.No office rate

How 23525 has changed in North Carolina

23525 · Office / nonfacility

$416.86

Effective 2026-10-01

The base rate is $37.95 higher than on 2025-10-01, moving from $378.91 to $416.86 (10.0%).

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

    $378.91changed to$416.86

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.79 changed to 3.70
    • Practice expense RVU 7.99 changed to 8.87
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $385.09changed to$378.91

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.84 changed to 7.99
    • Malpractice RVU 0.78 changed to 0.79

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $378.80changed to$385.09

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $387.29changed to$378.80

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.64 changed to 7.84
    • Malpractice RVU 0.75 changed to 0.78
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $389.02changed to$387.29

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.35 changed to 7.64
    • Malpractice RVU 0.77 changed to 0.75
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $385.89changed to$389.02

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.18 changed to 7.35
    • Malpractice RVU 0.74 changed to 0.77

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $381.07changed to$385.89

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.66 changed to 7.18
    • Malpractice RVU 0.76 changed to 0.74
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $375.98changed to$381.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.56 changed to 6.66
    • Malpractice RVU 0.77 changed to 0.76
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $373.47changed to$375.98

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.49 changed to 6.56
    • Malpractice RVU 0.78 changed to 0.77

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $358.96changed to$373.47

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.13 changed to 6.49
    • Malpractice RVU 0.69 changed to 0.78
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $362.16changed to$358.96

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.19 changed to 6.13
    • Malpractice RVU 0.74 changed to 0.69
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $372.81changed to$362.16

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.42 changed to 6.19
    • Malpractice RVU 0.80 changed to 0.74

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $370.96changed to$372.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $365.12changed to$370.96

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.34 changed to 6.42
    • Malpractice RVU 0.70 changed to 0.80
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $360.68changed to$365.12

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.80 changed to 6.34
    • Malpractice RVU 0.73 changed to 0.70
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $360.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$416.86$343.00RVU26D
2026-07-01$416.86$343.00RVU26C
2026-04-01$416.86$343.00RVU26B
2026-01-01$416.86$343.00RVU26A
2025-10-01$378.91$346.26RVU25D
2025-07-01$378.91$346.26RVU25C
2025-04-01$378.91$346.26RVU25B
2025-01-01$378.91$346.26RVU25A
2024-10-01$385.09$351.80RVU24D
2024-07-01$385.09$351.80RVU24C
2024-04-01$385.09$351.80RVU24B
2024-03-09$385.09$351.80RVU24AR
2024-01-01$378.80$346.06RVU24A
2023-10-01$387.29$354.62RVU23D
2023-07-01$387.29$354.62RVU23C
2023-04-01$387.29$354.62RVU23B
2023-01-01$387.29$354.62RVU23A
2022-10-01$389.02$356.59RVU22D
2022-07-01$389.02$356.59RVU22C
2022-04-01$389.02$356.59RVU22B
2022-01-01$389.02$356.59RVU22A
2021-10-01$385.89$354.15RVU21D
2021-07-01$385.89$354.15RVU21C
2021-04-01$385.89$354.15RVU21B
2021-01-01$385.89$354.15RVU21A
2020-10-01$381.07$351.20RVU20D
2020-07-01$381.07$351.20RVU20C
2020-04-01$381.07$351.20RVU20B
2020-01-01$381.07$351.20RVU20A
2019-10-01$375.98$346.79RVU19D
2019-07-01$375.98$346.79RVU19C
2019-04-01$375.98$346.79RVU19B
2019-01-01$375.98$346.79RVU19A
2018-10-01$373.47$344.98RVU18D
2018-07-01$373.47$344.98RVU18C
2018-04-01$373.47$344.98RVU18B
2018-01-01$373.47$344.98RVU18AR1
2017-10-01$358.96$332.90RVU17D
2017-07-01$358.96$332.90RVU17C
2017-04-01$358.96$332.90RVU17B
2017-01-01$358.96$332.90RVU17A
2016-10-01$362.16$335.52RVU16D
2016-07-01$362.16$335.52RVU16C
2016-04-01$362.16$335.52RVU16B
2016-01-01$362.16$335.52RVU16A
2015-10-01$372.81$345.41RVU15D
2015-07-01$372.81$345.41RVU15C
2015-04-01$370.96$343.69RVU15B
2015-01-01$370.96$343.69RVU15A
2014-10-01$365.12$338.49RVU14D
2014-07-01$365.12$338.49RVU14C
2014-04-01$365.12$338.49RVU14B
2014-01-01$365.12$338.49RVU14A
2013-10-01$360.68$333.55RVU13D
2013-07-01$360.68$333.55RVU13C
2013-04-01$360.68$333.55RVU13B
2013-01-01$360.68$333.55RVU13AR

Price 23525 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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

Show the CMS file lines behind this rate
RVUs for 23525PPRRVU2026_Oct_nonQPP.csv, line 2,222 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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