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CMS RVU26D · Effective 2026-10-01

23500 Clavicle fracture care Medicare reimbursement rates in Michigan

Reports nonoperative definitive care of a clavicle fracture when the clinician treats it without manipulating or manually repositioning the fracture fragments. Compare 23500 office and facility rates across CMS payment localities in Michigan.

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 23500 in Michigan?

Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

$245.22–$262.50

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $17.28 per service.

Facility setting

$233.33–$249.93

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $16.60 per service.

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.

Find 23500 in your payment locality →

Orthopedic fracture care

About 23500: Closed treatment of clavicle fracture

Reports nonoperative definitive care of a clavicle fracture when the clinician treats it without manipulating or manually repositioning the fracture fragments.

This service covers nonoperative management of a clavicle fracture without manually repositioning the fragments. Care may include assessing alignment, choosing support such as a sling, and providing activity restrictions and follow-up instructions. Orthopedic clinicians commonly provide the treatment in an outpatient clinic or emergency setting, or after referral from another clinician.

Report 23500 when the record supports definitive closed fracture care without manipulation, rather than evaluation alone. Document the affected clavicle, fracture diagnosis, treatment undertaken, and plan for immobilization and monitoring. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care. For procedures performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral treatment reported with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.

CMS billing rules for 23500

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 not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU2.15 · 28%
  • Practice expense (office) RVU5.13 · 66%
  • Malpractice RVU0.45 · 6%

10.8K

Medicare services in 2024 · #1435 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.

23500 compared with similar codes

Office rates for Michigan, from the same CMS release.

23505

Clavicle fracture

With manipulation

$389.94–$418.39

Both codes cover closed clavicle fracture care; 23505 is for treatment that includes manipulation, while 23500 is for treatment without it.

23515

Clavicle fracture repair

Open treatment

No office rate

Use 23515 when the clavicle fracture is treated operatively with internal fixation, rather than by closed care without manipulation.

23540

AC joint dislocation

Without manipulation

$262.72–$281.37

23540 addresses closed treatment of an acromioclavicular dislocation, not a fracture of the clavicle.

Compare 23500 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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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23500 billing questions

When should 23500 be chosen over 23505?

Use 23500 when definitive closed care is provided without manipulating the fracture. Use 23505 when the clinician manipulates the fracture.

Can the evaluation visit be billed separately?

The CMS 90-day global period includes the day-before preoperative visit and related postoperative care. Do not separately report routine care included in that global period.

How is treatment of both clavicles reported?

When both sides are treated, modifier 50 identifies the bilateral procedure; CMS pays it at 150%.

Is an assistant surgeon payable for this service?

No. CMS lists a statutory restriction on assistant-at-surgery payment for this code.

What documentation supports reporting 23500?

Document the clavicle fracture, the side treated, and the definitive closed treatment performed without manipulation, along with the immobilization and follow-up plan.

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.

RVUs for 23500PPRRVU2026_Oct_nonQPP.csv, line 2,218 (RVU26D)