Billing code 23620: Fracture careMedicare rate & RVUs in Georgia
Reports closed treatment of a greater tuberosity fracture of the humerus when the fracture is managed without manipulation.
Medicare pays $290.18–$316.59 for 23620 in the office in Georgia, from Rest Of Georgia to Atlanta. Which amount applies depends on the service address.
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 23620 covers
This code covers closed management of a fracture of the greater tuberosity, the prominence on the upper humerus where rotator cuff tendons attach. An orthopedic surgeon or other qualified clinician may use it when the fracture is treated without manipulating the bone fragments, such as with immobilization and a nonoperative care plan. Treatment may occur in an office, emergency department, or other setting where the clinician assumes fracture care.
Select the code when documentation identifies the greater tuberosity fracture and shows that no manipulation was performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral treatment reported with modifier 50, payment is at 150%. Medicare does not pay an assistant at surgery for this code; 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 23620 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | $316.59 | $277.90 |
| Rest Of Georgia | $290.18 | $256.21 |
How the 23620 rate is calculated
Each of 23620’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 · 23620
RVUs × geographic indexes × conversion factor
Work2.49
2.49 RVUs× 1.000 GPCI
Practice expense6.28
6.28 RVUs× 1.000 GPCI
Malpractice0.50
0.50 RVUs× 1.000 GPCI
Adjusted RVUs
9.2700
Conversion factor
$33.4009
Medicare rate
$309.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23620
23620 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23620
Fracture care
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 23620
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
23620 without 50 · national office
$309.63
Fracture care
23620-50 · Bilateral: 150%
$464.45
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).
23620 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 23625Fracture treatment
- Both codes concern greater tuberosity fractures; choose 23620 when no manipulation is performed and 23625 when the fracture is manipulated.
- 23600Fracture care
- 23620 is specific to the greater tuberosity. 23600 describes closed treatment without manipulation for a proximal humeral fracture not captured by that specific code.
- 23630Humeral fracture repair
- 23630 is for open treatment of a greater tuberosity fracture, including internal fixation when performed; 23620 describes closed treatment without manipulation.
- 23665Shoulder reduction
- 23665 describes closed treatment of a shoulder dislocation with an associated greater tuberosity fracture, rather than treatment of the tuberosity fracture alone.
23620 billing questions
When is 23620 used instead of 23625?
Use 23620 when the greater tuberosity fracture is treated without manipulating the fragments. If manipulation is performed, 23625 is the related code.
How does 23620 differ from 23600?
23620 identifies a fracture of the greater tuberosity specifically. 23600 is for closed treatment of a proximal humeral fracture without manipulation when the more specific greater-tuberosity code does not describe the fracture.
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.
How is bilateral treatment reported?
For bilateral treatment, report modifier 50; CMS pays the procedure at 150%.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 23620?
Document the greater tuberosity fracture, the affected side, the closed treatment plan, and that no manipulation was 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
Show the CMS file lines behind this rate
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