No office rate
Both involve partial clavicle removal. Choose according to the procedure documented: limited bone excision for this code versus partial claviculectomy for 23120.
On this page
CMS RVU26D · Effective 2026-10-01
23180 Clavicle excision Medicare reimbursement rates in Kentucky
Reports limited removal of clavicular bone, such as for focal diseased bone, when the operative work is less extensive than claviculectomy. Compare 23180 office and facility rates across CMS payment localities in Kentucky.
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 23180 in Kentucky?
Kentucky 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
$616.42
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 23180: Partial clavicle bone excision
Reports limited removal of clavicular bone, such as for focal diseased bone, when the operative work is less extensive than claviculectomy.
An orthopedic surgeon removes a limited portion of the clavicle, using an approach suited to the location and extent of the abnormal bone. This may be performed for focal bone disease, including infected or nonviable bone, when the procedure is a partial bone excision rather than removal of a sequestrum alone or resection of a larger clavicular segment. The service is generally performed in an operating room, and the operative report should identify the clavicle and the portion excised.
Select this code from the work documented, not simply from the diagnosis: record the site, extent of bone removed, indication, and relevant operative findings. Distinguish a limited excision from partial or total claviculectomy and from sequestrectomy. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 23180
- 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 RVU8.77 · 45%
- Practice expense (office) RVU8.98 · 46%
- Malpractice RVU1.86 · 9%
108
Medicare services in 2024 · #4819 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.
23180 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
23125 represents removal of the entire clavicle; this code is for limited removal of clavicular bone.
No office rate
23170 is specific to sequestrectomy of the clavicle. This code describes partial bone excision more generally.
No office rate
The procedures both involve partial bone excision, but 23182 is for the scapula and this code is for the clavicle.
Compare 23180 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$616.42
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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 23180 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,180
- Code
- 23180
- Physician work
- 8.77
- Practice expense
- 8.98
- Malpractice
- 1.86
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.77 | × 1.000 | 8.7700 |
| Practice expense | 8.98 | × 0.889 | 7.9832 |
| Malpractice | 1.86 | × 0.915 | 1.7019 |
| Total RVUs | 18.4551 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$616.42
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.77 | 1 |
| Practice expense | 8.98 | 0.889 |
| Malpractice | 1.86 | 0.915 |
(8.77 × 1 + 8.98 × 0.889 + 1.86 × 0.915) × $33.4009 = $616.42
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.
23180 billing questions
How is this code distinguished from partial claviculectomy?
Use this code for limited excision of clavicular bone. Compare the operative description with 23120, which represents partial claviculectomy; the documented procedure and extent determine the appropriate code.
When is clavicle sequestrectomy a better fit?
Use 23170 when the surgeon removes a sequestrum from the clavicle. This code describes partial bone excision rather than sequestrectomy specifically.
Can modifier 50 be reported for both clavicles?
Yes. CMS identifies this as a bilateral procedure; bilateral reporting with modifier 50 is paid at 150%.
Is the day-before visit included in the global period?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant-at-surgery be billed?
CMS lists a statutory restriction, so assistant-at-surgery payment is not made for this code. Co-surgeon payment requires 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 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.
2,17723170,,Sequestrectomy clavicle,A,,7.03,7.68,NA,7.68,,1.48,16.19,16.19,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17823172,,Sequestrectomy scapula,A,,7.13,7.71,NA,7.71,,1.50,16.34,16.34,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17923174,,Sqstrctmy humrl head srg nck,A,,9.80,9.81,NA,9.81,,2.09,21.70,21.70,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18023180,,Prtl excision bone clavicle,A,,8.77,8.98,NA,8.98,,1.86,19.61,19.61,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18123182,,Prtl excision bone scapula,A,,8.39,9.02,NA,9.02,,1.78,19.19,19.19,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18223184,,Prtl excision bone prox hum,A,,9.65,9.16,NA,9.16,,2.04,20.85,20.85,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,18323190,,Ostectomy scapula partial,A,,7.28,7.60,NA,7.60,,1.54,16.42,16.42,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631