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 in Chico
Office / nonfacility
$398.55
Base rate per service
Facility setting
$344.74
Base rate per service
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.
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 rates for Chico, from the same CMS release.
23615 describes open treatment with internal fixation. 23600 is for closed care without manipulation.
23620 is specific to a greater tuberosity fracture treated without manipulation; 23600 covers closed care of a proximal humerus fracture without manipulation.
The same code, a different location
How does Chico compare?
In Bakersfield, the office rate for 23600 is $400.23—$1.68 higher than the $398.55 rate in Chico. Both use the same code, release and participation basis.
23600 across payment areas
Same release and payment basis · bars start at $0
Chico · This locality
$398.55
$400.23
$1.68 higher than Chico
$398.65
$0.10 higher than Chico
$398.55
The same base rate than Chico
$398.55
The same base rate than Chico
$27.83 higher than Chico
$398.55
The same base rate than Chico
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
Across 109 of 109 CMS payment localities with a supported office rate, 23600 ranges from $334.16 in Arkansas to $498.60 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 23600
Office
$398.55
Facility
$344.74
The same base rate than Chico for the office setting.
Modesto
California · 23600
Office
$398.55
Facility
$344.74
The same base rate than Chico for the office setting.
Napa
California · 23600
Office
$460.84
Facility
$396.12
$62.29 higher than Chico for the office setting.
Oxnard-Thousand Oaks-Ventura
California · 23600
Office
$424.00
Facility
$365.97
$25.45 higher than Chico for the office setting.
Redding
California · 23600
Office
$398.55
Facility
$344.74
The same base rate than Chico for the office setting.
Rest Of California
California · 23600
Office
$398.55
Facility
$344.74
The same base rate than Chico for the office setting.
Riverside-San Bernardino-Ontario
California · 23600
Office
$405.11
Facility
$351.29
$6.56 higher than Chico for the office setting.
Sacramento-Roseville-Folsom
California · 23600
Office
$418.02
Facility
$360.92
$19.47 higher than Chico for the office setting.
Salinas
California · 23600
Office
$416.48
Facility
$359.57
$17.93 higher than Chico for the office setting.
San Diego-Chula Vista-Carlsbad
California · 23600
Office
$426.23
Facility
$367.51
$27.68 higher than Chico for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 23600
Office
$487.15
Facility
$417.92
$88.60 higher than Chico for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 23600
Office
$486.46
Facility
$417.23
$87.91 higher than Chico for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 23600
Office
$498.60
Facility
$427.80
$100.05 higher than Chico for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 23600
Office
$495.77
Facility
$424.97
$97.22 higher than Chico for the office setting.
San Luis Obispo-Paso Robles
California · 23600
Office
$409.85
Facility
$353.93
$11.30 higher than Chico for the office setting.
Santa Cruz-Watsonville
California · 23600
Office
$430.22
Facility
$370.57
$31.67 higher than Chico for the office setting.
Santa Maria-Santa Barbara
California · 23600
Office
$418.03
Facility
$360.78
$19.48 higher than Chico for the office setting.
Santa Rosa-Petaluma
California · 23600
Office
$434.52
Facility
$374.23
$35.97 higher than Chico for the office setting.
Stockton
California · 23600
Office
$398.55
Facility
$344.74
The same base rate than Chico for the office setting.
Vallejo
California · 23600
Office
$459.84
Facility
$395.13
$61.29 higher than Chico for the office setting.
Visalia
California · 23600
Office
$398.55
Facility
$344.74
The same base rate than Chico for the office setting.
Yuba City
California · 23600
Office
$398.55
Facility
$344.74
The same base rate than Chico for the office setting.
Dc + Md/Va Suburbs
District of Columbia · 23600
Office
$435.48
Facility
$377.64
$36.93 higher than Chico for the office setting.
Miami
Florida · 23600
Office
$423.03
Facility
$371.92
$24.48 higher than Chico for the office setting.
Chicago
Illinois · 23600
Office
$409.49
Facility
$360.14
$10.94 higher than Chico for the office setting.
Manhattan
New York · 23600
Office
$441.89
Facility
$384.84
$43.34 higher than Chico for the office setting.
Alaska*
Alaska · 23600
Office
$437.97
Facility
$385.68
$39.42 higher than Chico for the office setting.
Alabama
Alabama · 23600
Office
$339.40
Facility
$296.44
$59.15 lower than Chico for the office setting.
Arkansas
Arkansas · 23600
Office
$334.16
Facility
$291.98
$64.39 lower than Chico for the office setting.
Arizona
Arizona · 23600
Office
$370.02
Facility
$322.44
$28.53 lower than Chico for the office setting.
Colorado
Colorado · 23600
Office
$394.64
Facility
$342.40
$3.91 lower than Chico for the office setting.
Connecticut
Connecticut · 23600
Office
$407.58
Facility
$354.70
$9.03 higher than Chico for the office setting.
Delaware
Delaware · 23600
Office
$376.38
Facility
$327.87
$22.17 lower than Chico for the office setting.
Fort Lauderdale
Florida · 23600
Office
$400.98
Facility
$351.25
$2.43 higher than Chico for the office setting.
Rest Of Florida
Florida · 23600
Office
$379.79
Facility
$332.85
$18.76 lower than Chico for the office setting.
Atlanta
Georgia · 23600
Office
$389.70
Facility
$339.81
$8.85 lower than Chico for the office setting.
Rest Of Georgia
Georgia · 23600
Office
$356.63
Facility
$312.83
$41.92 lower than Chico for the office setting.
Hawaii, Guam
Hawaii · 23600
Office
$408.54
Facility
$352.71
$9.99 higher than Chico for the office setting.
Iowa
Iowa · 23600
Office
$346.47
Facility
$301.55
$52.08 lower than Chico for the office setting.
Idaho
Idaho · 23600
Office
$349.34
Facility
$304.17
$49.21 lower than Chico for the office setting.
East St. Louis
Illinois · 23600
Office
$380.73
Facility
$335.56
$17.82 lower than Chico for the office setting.
Rest Of Illinois
Illinois · 23600
Office
$369.71
Facility
$324.88
$28.84 lower than Chico for the office setting.
Suburban Chicago
Illinois · 23600
Office
$404.62
Facility
$354.19
$6.07 higher than Chico for the office setting.
Indiana
Indiana · 23600
Office
$351.44
Facility
$305.93
$47.11 lower than Chico for the office setting.
Kansas
Kansas · 23600
Office
$345.76
Facility
$301.38
$52.79 lower than Chico for the office setting.
Kentucky
Kentucky · 23600
Office
$350.19
Facility
$306.55
$48.36 lower than Chico for the office setting.
New Orleans
Louisiana · 23600
Office
$368.37
Facility
$322.16
$30.18 lower than Chico for the office setting.
Rest Of Louisiana
Louisiana · 23600
Office
$350.02
Facility
$306.57
$48.53 lower than Chico for the office setting.
Metropolitan Boston
Massachusetts · 23600
Office
$433.87
Facility
$375.25
$35.32 higher than Chico for the office setting.
Rest Of Massachusetts
Massachusetts · 23600
Office
$392.47
Facility
$340.76
$6.08 lower than Chico for the office setting.
Baltimore/Surr. Cntys
Maryland · 23600
Office
$406.69
Facility
$354.00
$8.14 higher than Chico for the office setting.
Rest Of Maryland
Maryland · 23600
Office
$383.57
Facility
$333.88
$14.98 lower than Chico for the office setting.
Rest Of Maine
Maine · 23600
Office
$352.37
Facility
$307.20
$46.18 lower than Chico for the office setting.
Southern Maine
Maine · 23600
Office
$371.22
Facility
$322.56
$27.33 lower than Chico for the office setting.
Detroit
Michigan · 23600
Office
$385.88
Facility
$338.50
$12.67 lower than Chico for the office setting.
Rest Of Michigan
Michigan · 23600
Office
$360.86
Facility
$316.04
$37.69 lower than Chico for the office setting.
Minnesota
Minnesota · 23600
Office
$374.38
Facility
$323.86
$24.17 lower than Chico for the office setting.
Metropolitan Kansas City
Missouri · 23600
Office
$364.60
Facility
$318.50
$33.95 lower than Chico for the office setting.
Metropolitan St. Louis
Missouri · 23600
Office
$368.53
Facility
$321.78
$30.02 lower than Chico for the office setting.
Rest Of Missouri
Missouri · 23600
Office
$344.30
Facility
$301.98
$54.25 lower than Chico for the office setting.
Mississippi
Mississippi · 23600
Office
$339.25
Facility
$296.97
$59.30 lower than Chico for the office setting.
Montana**
Montana · 23600
Office
$381.06
Facility
$331.96
$17.49 lower than Chico for the office setting.
North Carolina
North Carolina · 23600
Office
$356.14
Facility
$310.33
$42.41 lower than Chico for the office setting.
North Dakota**
North Dakota · 23600
Office
$369.00
Facility
$319.90
$29.55 lower than Chico for the office setting.
Nebraska
Nebraska · 23600
Office
$348.19
Facility
$302.87
$50.36 lower than Chico for the office setting.
New Hampshire
New Hampshire · 23600
Office
$389.33
Facility
$338.22
$9.22 lower than Chico for the office setting.
Northern Nj
New Jersey · 23600
Office
$430.71
Facility
$373.76
$32.16 higher than Chico for the office setting.
Rest Of New Jersey
New Jersey · 23600
Office
$411.18
Facility
$357.56
$12.63 higher than Chico for the office setting.
New Mexico
New Mexico · 23600
Office
$363.38
Facility
$318.36
$35.17 lower than Chico for the office setting.
Nevada**
Nevada · 23600
Office
$377.96
Facility
$328.82
$20.59 lower than Chico for the office setting.
Nyc Suburbs/Long Island
New York · 23600
Office
$454.51
Facility
$396.13
$55.96 higher than Chico for the office setting.
Poughkpsie/N Nyc Suburbs
New York · 23600
Office
$414.76
Facility
$361.00
$16.21 higher than Chico for the office setting.
Queens
New York · 23600
Office
$444.21
Facility
$386.18
$45.66 higher than Chico for the office setting.
Rest Of New York
New York · 23600
Office
$361.91
Facility
$315.27
$36.64 lower than Chico for the office setting.
Ohio
Ohio · 23600
Office
$358.40
Facility
$313.57
$40.15 lower than Chico for the office setting.
Oklahoma
Oklahoma · 23600
Office
$348.43
Facility
$304.59
$50.12 lower than Chico for the office setting.
Portland
Oregon · 23600
Office
$406.63
Facility
$352.08
$8.08 higher than Chico for the office setting.
Rest Of Oregon
Oregon · 23600
Office
$374.00
Facility
$325.10
$24.55 lower than Chico for the office setting.
Metropolitan Philadelphia
Pennsylvania · 23600
Office
$397.58
Facility
$346.46
$0.97 lower than Chico for the office setting.
Rest Of Pennsylvania
Pennsylvania · 23600
Office
$358.43
Facility
$313.36
$40.12 lower than Chico for the office setting.
Puerto Rico
Puerto Rico · 23600
Office
$383.69
Facility
$334.05
$14.86 lower than Chico for the office setting.
Rhode Island
Rhode Island · 23600
Office
$389.44
Facility
$338.72
$9.11 lower than Chico for the office setting.
South Carolina
South Carolina · 23600
Office
$358.07
Facility
$312.70
$40.48 lower than Chico for the office setting.
South Dakota**
South Dakota · 23600
Office
$367.58
Facility
$318.48
$30.97 lower than Chico for the office setting.
Tennessee
Tennessee · 23600
Office
$347.75
Facility
$303.12
$50.80 lower than Chico for the office setting.
Austin
Texas · 23600
Office
$394.22
Facility
$342.28
$4.33 lower than Chico for the office setting.
Beaumont
Texas · 23600
Office
$356.00
Facility
$311.32
$42.55 lower than Chico for the office setting.
Brazoria
Texas · 23600
Office
$375.04
Facility
$326.38
$23.51 lower than Chico for the office setting.
Dallas
Texas · 23600
Office
$378.04
Facility
$329.14
$20.51 lower than Chico for the office setting.
Fort Worth
Texas · 23600
Office
$375.68
Facility
$327.26
$22.87 lower than Chico for the office setting.
Galveston
Texas · 23600
Office
$376.54
Facility
$327.79
$22.01 lower than Chico for the office setting.
Houston
Texas · 23600
Office
$387.71
Facility
$338.95
$10.84 lower than Chico for the office setting.
Rest Of Texas
Texas · 23600
Office
$365.72
Facility
$319.13
$32.83 lower than Chico for the office setting.
Utah
Utah · 23600
Office
$363.25
Facility
$317.10
$35.30 lower than Chico for the office setting.
Virginia
Virginia · 23600
Office
$370.65
Facility
$322.38
$27.90 lower than Chico for the office setting.
Virgin Islands
United States Virgin Islands · 23600
Office
$383.69
Facility
$334.05
$14.86 lower than Chico for the office setting.
Vermont
Vermont · 23600
Office
$368.41
Facility
$319.80
$30.14 lower than Chico for the office setting.
Rest Of Washington
Washington · 23600
Office
$391.44
Facility
$339.74
$7.11 lower than Chico for the office setting.
Seattle (King Cnty)
Washington · 23600
Office
$441.94
Facility
$381.69
$43.39 higher than Chico for the office setting.
Wisconsin
Wisconsin · 23600
Office
$355.96
Facility
$308.93
$42.59 lower than Chico for the office setting.
West Virginia
West Virginia · 23600
Office
$355.45
Facility
$312.78
$43.10 lower than Chico for the office setting.
Wyoming**
Wyoming · 23600
Office
$375.81
Facility
$326.71
$22.74 lower than Chico for the office setting.
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 |
Where does this rate apply?
Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Why are the office and facility amounts different?
For 23600 in Chico, the physician’s office rate is $398.55 and the facility-setting rate is $344.74: a difference of $53.81.
The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 23600 in Chico. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$438.41
$398.55 × 110% = $438.41
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 23600 in Chico.
PPRRVU2026_Oct_nonQPP.csv
2,232
- Code
- 23600
- Physician work
- 2.93
- Practice expense
- 7.87
- Malpractice
- 0.61
GPCI2026.csv
9
- Locality
- Chico
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.93 | × 1.017 | 2.9798 |
| Practice expense | 7.87 | × 1.096 | 8.6255 |
| Malpractice | 0.61 | × 0.536 | 0.3270 |
| Total RVUs | 11.9323 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Chico$398.55
Open 23600 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1.017 |
| Practice expense | 7.87 | 1.096 |
| Malpractice | 0.61 | 0.536 |
(2.93 × 1.017 + 7.87 × 1.096 + 0.61 × 0.536) × $33.4009 = $398.55
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1.017 |
| Practice expense | 6.4 | 1.096 |
| Malpractice | 0.61 | 0.536 |
(2.93 × 1.017 + 6.4 × 1.096 + 0.61 × 0.536) × $33.4009 = $344.74
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
23600 · Office / nonfacility
$398.55
Effective 2026-10-01
The base rate is $42.15 higher than on 2025-10-01, moving from $356.40 to $398.55 (11.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$356.40changed to$398.55
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 3.00 changed to 2.93
- Practice expense RVU 6.99 changed to 7.87
- Malpractice RVU 0.60 changed to 0.61
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $356.40
Held through RVU25B, RVU25C, RVU25D.
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
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.
