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Billing code 23485: Clavicle osteotomyMedicare rate & RVUs

Report this service when a surgeon corrects clavicular alignment with an osteotomy and uses bone graft as part of the reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities150 Medicare services in 2024

Medicare pays $871.43 for 23485 nationally in a facility.

Medicare rate · 23485

Clavicle osteotomy

Swap in your local Medicare rate.

Work RVUs
13.56
Total RVUs
26.09
Global days
090

National rate · 2026

$871.43

Facility setting, before claim adjustments.

See every locality for 23485 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 23485 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 23485 covers

An orthopedic surgeon uses this service to correct a clavicle deformity or difficult healing problem by cutting and repositioning the bone and incorporating bone graft. A typical setting is the operating room, such as surgery to address a symptomatic clavicle malunion where correction requires graft support. The operative record should make clear that the clavicle was osteotomized and bone graft was used; a graft-only procedure or reinforcement without corrective osteotomy is a different service.

Select this code when the documented work includes both the clavicular osteotomy and graft, rather than the osteotomy service without graft. The 90-day global period includes 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. Modifier 50 identifies bilateral work, paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. CMS does not permit team-surgery payment for this service.

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 23485 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

23485 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$790.63
Alaska*Unavailable$1,077.71
ArizonaUnavailable$848.04
ArkansasUnavailable$780.71
AtlantaUnavailable$896.54
AustinUnavailable$880.75
BakersfieldUnavailable$875.32
Baltimore/Surr. CntysUnavailable$924.35
BeaumontUnavailable$835.51
BrazoriaUnavailable$851.83

23485 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
23485 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 23485 rate is calculated

Each of 23485’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 · 23485

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.56Practice expense 9.77Malpractice 2.76

26.0900 adjusted RVUs×$33.4009 conversion factor=$871.43

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 23485

23485 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23485

Clavicle osteotomy

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 23485

Clavicle osteotomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

23485 without 50 · national facility

$871.43

Clavicle osteotomy

23485-50 · Bilateral: 150%

$1,307.14

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

23485 compared with similar codes

Compare codes

23485 vs 23480 vs 23490 vs 23491: national Medicare rates

Swap in your local Medicare rate.

  • 23485
    Clavicle osteotomy · 13.56 wRVU
    —
  • 23480
    Clavicle osteotomy · 11.25 wRVU
    —
  • 23490
    Clavicle reinforcement · 11.86 wRVU
    —
  • 23491
    Scapular stabilization · 14.18 wRVU
    —

How to choose

23480Clavicle osteotomy
Choose 23485 when bone graft is used with the clavicular osteotomy. Choose 23480 for the osteotomy without that graft distinction.
23490Clavicle reinforcement
23490 describes reinforcement of the clavicle. This code represents corrective clavicular osteotomy with bone graft, not reinforcement alone.
23491Scapular stabilization
23491 concerns reinforcement of shoulder bones. Use 23485 when the documented service is a clavicular osteotomy performed with bone graft.

Codes related to 23485

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

Codes related to 23485
CodeHow it relatesNational office range
Same family
23480Clavicle osteotomyClavicular osteotomy without the bone-graft distinction.No office rate
Used instead
23490Clavicle reinforcementClavicle reinforcement addresses structural support rather than corrective osteotomy with graft.No office rate
23491Scapular stabilizationShoulder-bone reinforcement is a different approach when the goal is structural support.No office rate

23485 billing questions

How does this differ from 23480?

23485 is for clavicular osteotomy with bone graft. Use 23480 when the osteotomy is performed without the graft distinction.

Is the bone graft part of this service?

Yes. The code identifies a clavicular osteotomy performed with bone graft, so documentation should support both the osteotomy and graft use.

Does the 90-day global include postoperative visits?

It includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral work reported?

Use modifier 50 for bilateral work; CMS payment for this code is at 150%.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.

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 23485PPRRVU2026_Oct_nonQPP.csv, line 2,215 (RVU26D)

Open CMS sourceHow we calculate rates

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