No office rate
Choose 23485 when the osteotomy is for clavicular nonunion or malunion. Code 23480 is for a clavicle osteotomy for another indication.
On this page
CMS RVU26D · Effective 2026-10-01
23480 Clavicle osteotomy Medicare reimbursement rates in Guam
Reports a planned clavicle bone cut to correct alignment or shape, with or without fixation, rather than treatment of an acute fracture. Compare 23480 office and facility rates across CMS payment localities in Guam.
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 23480 in Guam?
Guam has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$772.32
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
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.
Orthopedic surgery
About 23480: Clavicle osteotomy for alignment correction
Reports a planned clavicle bone cut to correct alignment or shape, with or without fixation, rather than treatment of an acute fracture.
An orthopedic surgeon cuts and reshapes the clavicle to correct a structural alignment problem. The surgeon may use plates, screws, or other internal fixation to hold the bone in its corrected position. This is generally performed in an operating room, such as a hospital or ambulatory surgical facility, when a planned osteotomy is needed rather than routine fracture fixation or treatment of a nonunion or malunion.
The operative report should identify the clavicle, the reason for the osteotomy, the bone cut and correction performed, and any fixation used. Internal fixation used to stabilize the osteotomy is part of the service. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one 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 is statutorily restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 23480
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.25 · 49%
- Practice expense (office) RVU9.22 · 40%
- Malpractice RVU2.40 · 10%
48
Medicare services in 2024 · #5371 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.
23480 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
This code concerns a planned osteotomy for correction; 23515 is for open treatment of a clavicle fracture.
No office rate
Code 23490 addresses prophylactic reinforcement of the clavicle. Code 23480 involves cutting and correcting the bone's alignment or shape.
Compare 23480 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.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$772.32
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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 23480 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,214
- Code
- 23480
- Physician work
- 11.25
- Practice expense
- 9.22
- Malpractice
- 2.40
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.25 | × 1.000 | 11.2500 |
| Practice expense | 9.22 | × 1.137 | 10.4831 |
| Malpractice | 2.40 | × 0.579 | 1.3896 |
| Total RVUs | 23.1227 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$772.32
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.25 | 1 |
| Practice expense | 9.22 | 1.137 |
| Malpractice | 2.4 | 0.579 |
(11.25 × 1 + 9.22 × 1.137 + 2.4 × 0.579) × $33.4009 = $772.32
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.
23480 billing questions
How does this differ from 23485?
Use 23480 for a clavicle osteotomy for a reason other than treatment of a nonunion or malunion. Code 23485 is the related option when the osteotomy addresses a clavicular nonunion or malunion.
Is internal fixation separately reported?
Fixation used to stabilize the osteotomy is included in this service. Document the fixation performed, but do not report a separate fixation procedure solely for that stabilization.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care. The operative and follow-up documentation should support the relationship of care to the surgery.
How is bilateral clavicle surgery reported?
When the procedure is performed bilaterally, report modifier 50. CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment is subject to a statutory restriction for this code. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
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.
2,21123472,,Reconstruct shoulder joint,A,,21.58,12.99,NA,12.99,,4.36,38.93,38.93,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21223473,,Revis reconst shoulder joint,A,,24.38,13.85,NA,13.85,,4.89,43.12,43.12,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21323474,,Revis reconst shoulder joint,A,,26.53,14.56,NA,14.56,,5.38,46.47,46.47,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21423480,,Revision of collar bone,A,,11.25,9.22,NA,9.22,,2.40,22.87,22.87,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21523485,,Revision of collar bone,A,,13.56,9.77,NA,9.77,,2.76,26.09,26.09,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21623490,,Reinforce clavicle,A,,11.86,9.58,NA,9.58,,2.53,23.97,23.97,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21723491,,Reinforce shoulder bones,A,,14.18,10.87,NA,10.87,,3.02,28.07,28.07,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014