Billing code 23680: Shoulder fracture-dislocationMedicare rate & RVUs in Florida
Open operative treatment of a shoulder dislocation accompanied by a humeral surgical-neck fracture, including fixation when performed.
CMS doesn’t publish an office rate for 23680 in Florida.
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 9 sections
What 23680 covers
Code 23680 describes operative management of a shoulder whose humeral head is dislocated and whose humerus is fractured through the surgical neck. The surgeon exposes the injury, restores joint alignment, and treats the associated fracture; internal fixation is included when performed. Orthopedic surgeons typically perform this combined procedure in an operating room for traumatic fracture-dislocations requiring open treatment rather than closed reduction alone.
Report the code when the operative record supports both the shoulder dislocation and surgical-neck fracture and documents open treatment; identify the fracture location and work performed. The code includes fixation when performed, so do not separately report the same operative work as an unrelated dislocation or fracture procedure. Its 90-day global period includes the day before surgery and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is 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 23680 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $943.25 |
| Miami | Unavailable | $1,018.68 |
| Rest Of Florida | Unavailable | $895.74 |
How the 23680 rate is calculated
Each of 23680’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 · 23680
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.82Practice expense 10.35Malpractice 2.73
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23680
23680 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23680
Shoulder fracture-dislocation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 23680
Shoulder fracture-dislocation
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
23680 without 50 · national facility
$865.08
Shoulder fracture-dislocation
23680-50 · Bilateral: 150%
$1,297.62
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).
23680 compared with similar codes
Compare codes
23680 vs 23675 vs 23670 vs 23615: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23675Shoulder reduction
- Choose 23675 for closed treatment with manipulation of a shoulder dislocation and surgical-neck fracture; 23680 describes open treatment.
- 23670Shoulder surgery
- Both describe open treatment of a shoulder dislocation with an associated humeral fracture, but 23670 is for a greater-tuberosity fracture, not a surgical-neck fracture.
- 23615Fracture repair
- 23615 addresses open fixation of a proximal humeral fracture. Use 23680 when the treated injury also includes a shoulder dislocation and the fracture is at the surgical neck.
23680 billing questions
How does 23680 differ from 23675?
Use 23680 for open treatment of the shoulder dislocation with a surgical-neck fracture. Code 23675 describes closed treatment with manipulation.
Is fracture fixation included in 23680?
Yes. Internal fixation is included when performed as part of the open treatment, so do not separately report the same fixation work.
Can modifier 50 be reported for bilateral treatment?
The CMS rule identifies this as a bilateral procedure; when reported bilaterally with modifier 50, payment is 150%.
What documentation supports reporting 23680?
Document the shoulder dislocation, the humeral fracture at the surgical neck, and the open treatment performed. The operative report should make clear that both injuries were treated.
How are assistant and co-surgeon claims handled?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation.
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
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