$470.16–$683.76
Choose 23605 when closed treatment includes manipulation, with or without traction. Choose 23600 when the fracture is treated without manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
23600 Fracture care Medicare reimbursement rates
Reports definitive closed care of a proximal humerus fracture when the clinician manages the fracture without manipulating the bone fragments. Compare 23600 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 23600?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$334.16–$498.60
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $164.44 per service.
Facility setting
$291.98–$427.80
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $135.82 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 23600 pays more and less
109 payment localities
$334.16 to $498.60
Orthopedic fracture care
About 23600: Proximal humerus fracture care without manipulation
Reports definitive closed care of a proximal humerus fracture when the clinician manages the fracture without manipulating the bone fragments.
CPT 23600 represents definitive closed fracture care for a proximal humerus fracture when the clinician treats it without manipulating the fragments. Typical cases involve fractures managed with a sling or shoulder immobilizer rather than reduction, after imaging confirms the injury. Orthopedic surgeons, emergency physicians, or other clinicians may provide the initial care in an office, emergency department, or hospital setting.
Select this code based on the fracture location and treatment performed: the fracture involves the proximal humerus, is treated closed, and is not manipulated. Documentation should support the fracture diagnosis, affected side, imaging findings, and treatment plan, including that no manipulation was performed. Medicare assigns a 90-day major-surgery global period; the day-before preoperative visit and related postoperative care during that period are included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 23600
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.93 · 26%
- Practice expense (office) RVU7.87 · 69%
- Malpractice RVU0.61 · 5%
25.3K
Medicare services in 2024 · #1046 by national volume
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.
23600 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
23615 describes open treatment with internal fixation. 23600 is for closed care without manipulation.
$271.95–$403.74
23620 is specific to a greater tuberosity fracture treated without manipulation; 23600 covers closed care of a proximal humerus fracture without manipulation.
See how rates vary across the country
23600 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$334.16
$448.58
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $437.97 | 1 |
| AL | $339.40 | 1 |
| AR | $334.16 | 1 |
| AZ | $370.02 | 1 |
| CA | $398.55–$498.60 | 29 |
| CO | $394.64 | 1 |
| CT | $407.58 | 1 |
| DC | $435.48 | 1 |
| DE | $376.38 | 1 |
| FL | $379.79–$423.03 | 3 |
| GA | $356.63–$389.70 | 2 |
| GU | $408.54 | 1 |
| HI | $408.54 | 1 |
| IA | $346.47 | 1 |
| ID | $349.34 | 1 |
| IL | $369.71–$409.49 | 4 |
| IN | $351.44 | 1 |
| KS | $345.76 | 1 |
| KY | $350.19 | 1 |
| LA | $350.02–$368.37 | 2 |
| MA | $392.47–$433.87 | 2 |
| MD | $383.57–$435.48 | 3 |
| ME | $352.37–$371.22 | 2 |
| MI | $360.86–$385.88 | 2 |
| MN | $374.38 | 1 |
| MO | $344.30–$368.53 | 3 |
| MS | $339.25 | 1 |
| MT | $381.06 | 1 |
| NC | $356.14 | 1 |
| ND | $369.00 | 1 |
| NE | $348.19 | 1 |
| NH | $389.33 | 1 |
| NJ | $411.18–$430.71 | 2 |
| NM | $363.38 | 1 |
| NV | $377.96 | 1 |
| NY | $361.91–$454.51 | 5 |
| OH | $358.40 | 1 |
| OK | $348.43 | 1 |
| OR | $374.00–$406.63 | 2 |
| PA | $358.43–$397.58 | 2 |
| PR | $383.69 | 1 |
| RI | $389.44 | 1 |
| SC | $358.07 | 1 |
| SD | $367.58 | 1 |
| TN | $347.75 | 1 |
| TX | $356.00–$394.22 | 8 |
| UT | $363.25 | 1 |
| VA | $370.65–$435.48 | 2 |
| VI | $383.69 | 1 |
| VT | $368.41 | 1 |
| WA | $391.44–$441.94 | 2 |
| WI | $355.96 | 1 |
| WV | $355.45 | 1 |
| WY | $375.81 | 1 |
Compare 23600 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $339.40 | Facility $296.44 |
| Alaska* | Office $437.97 | Facility $385.68 |
| Arizona | Office $370.02 | Facility $322.44 |
| Arkansas | Office $334.16 | Facility $291.98 |
| Atlanta | Office $389.70 | Facility $339.81 |
| Austin | Office $394.22 | Facility $342.28 |
| Bakersfield | Office $400.23 | Facility $346.42 |
| Baltimore/Surr. Cntys | Office $406.69 | Facility $354.00 |
| Beaumont | Office $356.00 | Facility $311.32 |
| Brazoria | Office $375.04 | Facility $326.38 |
| Chicago | Office $409.49 | Facility $360.14 |
| Chico | Office $398.55 | Facility $344.74 |
| Colorado | Office $394.64 | Facility $342.40 |
| Connecticut | Office $407.58 | Facility $354.70 |
| Dallas | Office $378.04 | Facility $329.14 |
| Dc + Md/Va Suburbs | Office $435.48 | Facility $377.64 |
| Delaware | Office $376.38 | Facility $327.87 |
| Detroit | Office $385.88 | Facility $338.50 |
| East St. Louis | Office $380.73 | Facility $335.56 |
| El Centro | Office $398.65 | Facility $344.84 |
| Fort Lauderdale | Office $400.98 | Facility $351.25 |
| Fort Worth | Office $375.68 | Facility $327.26 |
| Fresno | Office $398.55 | Facility $344.74 |
| Galveston | Office $376.54 | Facility $327.79 |
| Hanford-Corcoran | Office $398.55 | Facility $344.74 |
| Hawaii, Guam | Office $408.54 | Facility $352.71 |
| Houston | Office $387.71 | Facility $338.95 |
| Idaho | Office $349.34 | Facility $304.17 |
| Indiana | Office $351.44 | Facility $305.93 |
| Iowa | Office $346.47 | Facility $301.55 |
| Kansas | Office $345.76 | Facility $301.38 |
| Kentucky | Office $350.19 | Facility $306.55 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $426.38 | Facility $368.29 |
| Madera | Office $398.55 | Facility $344.74 |
| Manhattan | Office $441.89 | Facility $384.84 |
| Merced | Office $398.55 | Facility $344.74 |
| Metropolitan Boston | Office $433.87 | Facility $375.25 |
| Metropolitan Kansas City | Office $364.60 | Facility $318.50 |
| Metropolitan Philadelphia | Office $397.58 | Facility $346.46 |
| Metropolitan St. Louis | Office $368.53 | Facility $321.78 |
| Miami | Office $423.03 | Facility $371.92 |
| Minnesota | Office $374.38 | Facility $323.86 |
| Mississippi | Office $339.25 | Facility $296.97 |
| Modesto | Office $398.55 | Facility $344.74 |
| Montana** | Office $381.06 | Facility $331.96 |
| Napa | Office $460.84 | Facility $396.12 |
| Nebraska | Office $348.19 | Facility $302.87 |
| Nevada** | Office $377.96 | Facility $328.82 |
| New Hampshire | Office $389.33 | Facility $338.22 |
| New Mexico | Office $363.38 | Facility $318.36 |
| New Orleans | Office $368.37 | Facility $322.16 |
| North Carolina | Office $356.14 | Facility $310.33 |
| North Dakota** | Office $369.00 | Facility $319.90 |
| Northern Nj | Office $430.71 | Facility $373.76 |
| Nyc Suburbs/Long Island | Office $454.51 | Facility $396.13 |
| Ohio | Office $358.40 | Facility $313.57 |
| Oklahoma | Office $348.43 | Facility $304.59 |
| Oxnard-Thousand Oaks-Ventura | Office $424.00 | Facility $365.97 |
| Portland | Office $406.63 | Facility $352.08 |
| Poughkpsie/N Nyc Suburbs | Office $414.76 | Facility $361.00 |
| Puerto Rico | Office $383.69 | Facility $334.05 |
| Queens | Office $444.21 | Facility $386.18 |
| Redding | Office $398.55 | Facility $344.74 |
| Rest Of California | Office $398.55 | Facility $344.74 |
| Rest Of Florida | Office $379.79 | Facility $332.85 |
| Rest Of Georgia | Office $356.63 | Facility $312.83 |
| Rest Of Illinois | Office $369.71 | Facility $324.88 |
| Rest Of Louisiana | Office $350.02 | Facility $306.57 |
| Rest Of Maine | Office $352.37 | Facility $307.20 |
| Rest Of Maryland | Office $383.57 | Facility $333.88 |
| Rest Of Massachusetts | Office $392.47 | Facility $340.76 |
| Rest Of Michigan | Office $360.86 | Facility $316.04 |
| Rest Of Missouri | Office $344.30 | Facility $301.98 |
| Rest Of New Jersey | Office $411.18 | Facility $357.56 |
| Rest Of New York | Office $361.91 | Facility $315.27 |
| Rest Of Oregon | Office $374.00 | Facility $325.10 |
| Rest Of Pennsylvania | Office $358.43 | Facility $313.36 |
| Rest Of Texas | Office $365.72 | Facility $319.13 |
| Rest Of Washington | Office $391.44 | Facility $339.74 |
| Rhode Island | Office $389.44 | Facility $338.72 |
| Riverside-San Bernardino-Ontario | Office $405.11 | Facility $351.29 |
| Sacramento-Roseville-Folsom | Office $418.02 | Facility $360.92 |
| Salinas | Office $416.48 | Facility $359.57 |
| San Diego-Chula Vista-Carlsbad | Office $426.23 | Facility $367.51 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $487.15 | Facility $417.92 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $486.46 | Facility $417.23 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $498.60 | Facility $427.80 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $495.77 | Facility $424.97 |
| San Luis Obispo-Paso Robles | Office $409.85 | Facility $353.93 |
| Santa Cruz-Watsonville | Office $430.22 | Facility $370.57 |
| Santa Maria-Santa Barbara | Office $418.03 | Facility $360.78 |
| Santa Rosa-Petaluma | Office $434.52 | Facility $374.23 |
| Seattle (King Cnty) | Office $441.94 | Facility $381.69 |
| South Carolina | Office $358.07 | Facility $312.70 |
| South Dakota** | Office $367.58 | Facility $318.48 |
| Southern Maine | Office $371.22 | Facility $322.56 |
| Stockton | Office $398.55 | Facility $344.74 |
| Suburban Chicago | Office $404.62 | Facility $354.19 |
| Tennessee | Office $347.75 | Facility $303.12 |
| Utah | Office $363.25 | Facility $317.10 |
| Vallejo | Office $459.84 | Facility $395.13 |
| Vermont | Office $368.41 | Facility $319.80 |
| Virgin Islands | Office $383.69 | Facility $334.05 |
| Virginia | Office $370.65 | Facility $322.38 |
| Visalia | Office $398.55 | Facility $344.74 |
| West Virginia | Office $355.45 | Facility $312.78 |
| Wisconsin | Office $355.96 | Facility $308.93 |
| Wyoming** | Office $375.81 | Facility $326.71 |
| Yuba City | Office $398.55 | Facility $344.74 |
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23600 billing questions
When should 23600 be chosen instead of 23605?
Use 23600 when the proximal humerus fracture is treated without manipulating the fragments. Code 23605 describes closed treatment that includes manipulation, with or without traction.
Are routine fracture follow-up visits included?
Related postoperative care during the 90-day global period is included, along with the day-before preoperative visit.
Can modifier 50 be reported when both shoulders are treated?
Yes. CMS classifies this as a bilateral procedure; modifier 50 is paid at 150%.
How does Medicare handle an assistant or co-surgeon?
An assistant at surgery is not paid for this service. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,22923570,,Cltx scapular fx w/o mnpj,A,,2.30,5.19,,4.80,,0.47,7.96,7.57,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23023575,,Cltx scap fx w/mnpj +-tractj,A,,4.12,8.74,,6.35,,0.88,13.74,11.35,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23123585,,Optx scapular fx w/int fixj,A,,13.87,10.12,NA,10.12,,2.82,26.81,26.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23223600,,Cltx prox humrl fx w/o mnpj,A,,2.93,7.87,,6.40,,0.61,11.41,9.94,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23323605,,Cltx prx hmrl fx mnpj+-tract,A,,4.93,10.00,,7.19,,1.08,16.01,13.20,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23423615,,Optx prox humrl fx w/int fix,A,,11.99,10.18,NA,10.18,,2.49,24.66,24.66,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23523616,,Optx prx hmrl fx fix rpr rpl,A,,17.91,11.97,NA,11.97,,3.70,33.58,33.58,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00