Billing code 23570: Scapular fracture careMedicare rate & RVUs

Reports closed, nonoperative management of a scapular fracture when the treating clinician accepts alignment without manipulating the fracture.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.4K Medicare services in 2024

Medicare pays $265.87 for 23570 nationally in the office and $252.84 in a hospital or facility. Local office rates run $233.81–$343.66.

Medicare rate · 23570

Scapular fracture care

Swap in your local Medicare rate.

Work RVUs
2.3
Total RVUs
7.96
Global days
090

National rate · 2026

$265.87

Office setting, before claim adjustments.

See every locality for 23570 → · 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 23570 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 23570 covers

An orthopedic surgeon or other physician managing a scapular fracture may report this service when treatment is closed and alignment is accepted without manipulation. Care may include clinical assessment, nonoperative immobilization such as a sling when appropriate, and management of healing. The record should identify the fracture site and support that the clinician is assuming fracture care, rather than only evaluating the injury before referral. Treatment may occur in an office or hospital setting.

Document the fracture site and pattern, the closed approach, the decision not to manipulate, and the care plan. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral treatment with modifier 50 is paid at 150%. Assistant-at-surgery services are subject to a statutory payment restriction; 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 23570 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$233.81 to $343.66

$233.81$288.74$343.66
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

23570 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$237.39$225.99
Alaska*$308.50$294.63
Arizona$258.24$245.61
Arkansas$233.81$222.63
Atlanta$272.03$258.80
Austin$274.29$260.51
Bakersfield$277.83$263.56
Baltimore/Surr. Cntys$283.48$269.50
Beaumont$249.16$237.30
Brazoria$261.47$248.56

23570 rates by state

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

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.

$233.81

$310.10

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

View every state and territory as a table
23570 office rate range by state
State / territoryOffice rate rangeLocalities
AK$308.501
AL$237.391
AR$233.811
AZ$258.241
CA$276.53–$343.6629
CO$274.451
CT$284.051
DC$302.651
DE$262.591
FL$266.14–$296.983
GA$250.16–$272.032
GU$283.011
HI$283.011
IA$241.671
ID$243.731
IL$259.63–$287.614
IN$245.151
KS$241.441
KY$245.291
LA$245.28–$257.782
MA$273.10–$300.922
MD$267.43–$302.653
ME$246.07–$258.522
MI$252.81–$270.572
MN$259.851
MO$241.54–$257.583
MS$237.681
MT$265.841
NC$248.591
ND$256.551
NE$242.761
NH$271.021
NJ$286.42–$299.512
NM$254.641
NV$263.421
NY$252.54–$317.005
OH$250.921
OK$243.821
OR$260.52–$282.322
PA$250.79–$277.392
PR$267.541
RI$271.361
SC$250.341
SD$255.451
TN$242.831
TX$249.16–$274.298
UT$253.871
VA$258.31–$302.652
VI$267.541
VT$256.381
WA$272.31–$306.192
WI$247.731
WV$249.931
WY$261.791

How the 23570 rate is calculated

Each of 23570’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 · 23570

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.30Practice expense 5.19Malpractice 0.47

7.9600 adjusted RVUs×$33.4009 conversion factor=$265.87

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

Payment rules and modifiers for 23570

23570 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23570

Scapular fracture care

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)1Not paid (statutory restriction).
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 · 23570

Scapular fracture care

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

23570 without 50 · national office

$265.87

Scapular fracture care

23570-50 · Bilateral: 150%

$398.81

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

23570 compared with similar codes

Compare codes

23570 vs 23575 vs 23585 vs 23500: national Medicare rates

Swap in your local Medicare rate.

  • 23570
    Scapular fracture care · 2.3 wRVU
    $265.87
  • 23575
    Scapula fracture · 4.12 wRVU
    $458.93+$193.06
  • 23585
    Scapular fracture repair · 13.87 wRVU
    —
  • 23500
    Clavicle fracture care · 2.15 wRVU
    $258.19−$7.68

How to choose

23575Scapula fracture
Both describe closed treatment of a scapular fracture; 23575 is the choice when manipulation is performed, while 23570 is for treatment without manipulation.
23585Scapular fracture repair
Choose 23585 when the scapular fracture is treated through an open approach with internal fixation; 23570 describes closed treatment without manipulation.
23500Clavicle fracture care
23500 is for closed treatment without manipulation of a clavicular fracture. Confirm whether the fractured bone is the clavicle or the scapula.

23570 billing questions

When should 23570 be chosen over 23575?

Report 23570 when the scapular fracture is treated closed without manipulation. Use 23575 when the clinician manipulates the fracture as part of closed treatment.

How does 23570 differ from 23585?

23570 describes closed treatment without manipulation. 23585 is for open treatment of a scapular fracture with internal fixation.

Does applying a sling alone support 23570?

The documentation should show that the clinician assumed fracture care and selected closed treatment without manipulation. A sling application by itself does not establish those facts.

Are related follow-up visits included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral treatment reported?

For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be paid for this service?

CMS applies a statutory restriction to assistant-at-surgery payment. Co-surgeons and team surgery are 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 23570PPRRVU2026_Oct_nonQPP.csv, line 2,229 (RVU26D)

Open CMS sourceHow we calculate rates

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