No office rate
Choose 23485 when bone graft is used with the clavicular osteotomy. Choose 23480 for the osteotomy without that graft distinction.
On this page
CMS RVU26D · Effective 2026-10-01
23485 Clavicle osteotomy Medicare reimbursement rates in Idaho
Report this service when a surgeon corrects clavicular alignment with an osteotomy and uses bone graft as part of the reconstruction. Compare 23485 office and facility rates across CMS payment localities in Idaho.
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 23485 in Idaho?
Idaho 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
$796.74
1 of 1 localities have a supported rate.
Payment area: Idaho
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 23485: Clavicle osteotomy with bone graft
Report this service when a surgeon corrects clavicular alignment with an osteotomy and uses bone graft as part of the reconstruction.
An orthopedic surgeon uses this service to correct a clavicle deformity or difficult healing problem by cutting and repositioning the bone and incorporating bone graft. A typical setting is the operating room, such as surgery to address a symptomatic clavicle malunion where correction requires graft support. The operative record should make clear that the clavicle was osteotomized and bone graft was used; a graft-only procedure or reinforcement without corrective osteotomy is a different service.
Select this code when the documented work includes both the clavicular osteotomy and graft, rather than the osteotomy service without graft. 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 other procedures are subject to the standard 50% reduction. Modifier 50 identifies bilateral work, paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. CMS does not permit team-surgery payment for this service.
CMS billing rules for 23485
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.56 · 52%
- Practice expense (office) RVU9.77 · 37%
- Malpractice RVU2.76 · 11%
150
Medicare services in 2024 · #4561 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.
23485 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
23490 describes reinforcement of the clavicle. This code represents corrective clavicular osteotomy with bone graft, not reinforcement alone.
No office rate
23491 concerns reinforcement of shoulder bones. Use 23485 when the documented service is a clavicular osteotomy performed with bone graft.
Compare 23485 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
Idaho →
Office / nonfacility
Unavailable
Facility
$796.74
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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 23485 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
2,215
- Code
- 23485
- Physician work
- 13.56
- Practice expense
- 9.77
- Malpractice
- 2.76
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.56 | × 1.000 | 13.5600 |
| Practice expense | 9.77 | × 0.920 | 8.9884 |
| Malpractice | 2.76 | × 0.473 | 1.3055 |
| Total RVUs | 23.8539 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$796.74
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.56 | 1 |
| Practice expense | 9.77 | 0.92 |
| Malpractice | 2.76 | 0.473 |
(13.56 × 1 + 9.77 × 0.92 + 2.76 × 0.473) × $33.4009 = $796.74
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.
23485 billing questions
How does this differ from 23480?
23485 is for clavicular osteotomy with bone graft. Use 23480 when the osteotomy is performed without the graft distinction.
Is the bone graft part of this service?
Yes. The code identifies a clavicular osteotomy performed with bone graft, so documentation should support both the osteotomy and graft use.
Does the 90-day global include postoperative visits?
It includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral work reported?
Use modifier 50 for bilateral work; CMS payment for this code is at 150%.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team-surgery payment 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.
2,21223473,,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
2,21823500,,Cltx clavicular fx w/o mnpj,A,,2.15,5.13,,4.74,,0.45,7.73,7.34,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772