Billing code 23575: Scapula fractureMedicare rate & RVUs

Medicare pays $458.93 for 23575 nationally in the office and $379.10 in a hospital or facility. Local office rates run $403.51–$589.46.

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

What 23575 covers

This service covers closed treatment of a scapular fracture when the physician manipulates the fragments to improve alignment, with or without skeletal traction. An orthopedic surgeon or other qualified physician may provide it after trauma involving the scapular body, neck, or glenoid region. Treatment is performed without surgically exposing the fracture; the clinical setting depends on the injury and the reduction required.

Report the code when the treatment includes manipulation, not for closed care without manipulation. The record should identify the scapular fracture and document the reduction and any traction used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 indicates bilateral treatment and 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.

Where 23575 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

23575 rates by state

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

How the 23575 rate is calculated

Each of 23575’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 23575

23575 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

23575 compared with similar codes

How to choose

23570Scapular fracture care

Both describe closed scapular fracture treatment. Choose 23575 when manipulation is performed; 23570 applies when it is not.

23585Scapular fracture repair

Use 23585 for open treatment of a scapular fracture, including internal fixation when performed. Use 23575 for closed treatment with manipulation.

23505Clavicle fracture

Code 23505 is for closed treatment with manipulation of a clavicular fracture. Code 23575 is for a scapular fracture.

Codes related to 23575

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

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