No office rate
23120 is for partial clavicle removal. Choose 23125 when the operative report supports resection of the complete clavicle.
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CMS RVU26D · Effective 2026-10-01
23125 Claviculectomy Medicare reimbursement rates in Minnesota
Report complete clavicle removal when the surgeon resects the entire clavicle, rather than removing only part of the bone or a focal lesion. Compare 23125 office and facility rates across CMS payment localities in Minnesota.
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 23125 in Minnesota?
Minnesota 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
$630.35
1 of 1 localities have a supported rate.
Payment area: Minnesota
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 23125: Complete clavicle removal
Report complete clavicle removal when the surgeon resects the entire clavicle, rather than removing only part of the bone or a focal lesion.
An orthopedic surgeon removes the entire clavicle through an operative approach to the shoulder girdle. The procedure may be performed in a hospital or other surgical facility when the treatment plan calls for complete removal of the bone; the operative report should make clear that the resection involved the full clavicle, not just its distal end or a localized area.
Report this code for complete claviculectomy, distinguishing it from partial removal and procedures directed at a focal bone lesion or sequestrum. Documentation should identify the side, extent of resection, and operative findings. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment may be available; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 23125
- 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 RVU9.40 · 47%
- Practice expense (office) RVU8.63 · 43%
- Malpractice RVU2.00 · 10%
20
Medicare services in 2024 · #5908 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.
23125 compared with similar codes
Office rates for Minnesota, from the same CMS release.
No office rate
23140 addresses a bone lesion in the clavicle; 23125 represents removal of the entire bone, not just a focal lesion.
No office rate
23170 is for removal of a clavicular sequestrum. It does not describe complete claviculectomy.
Compare 23125 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
Minnesota →
Office / nonfacility
Unavailable
Facility
$630.35
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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 23125 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
2,169
- Code
- 23125
- Physician work
- 9.40
- Practice expense
- 8.63
- Malpractice
- 2.00
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.40 | × 1.000 | 9.4000 |
| Practice expense | 8.63 | × 1.029 | 8.8803 |
| Malpractice | 2.00 | × 0.296 | 0.5920 |
| Total RVUs | 18.8723 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$630.35
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.4 | 1 |
| Practice expense | 8.63 | 1.029 |
| Malpractice | 2 | 0.296 |
(9.4 × 1 + 8.63 × 1.029 + 2 × 0.296) × $33.4009 = $630.35
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.
23125 billing questions
How do I distinguish this code from partial claviculectomy?
Use this code when the operative report documents removal of the entire clavicle. Partial clavicle removal is reported with 23120.
Can a focal clavicle lesion be reported with this code?
The extent of the operation controls: this code represents removal of the whole clavicle, while a localized lesion procedure may be appropriate when only the lesion is treated. The operative report should establish the actual extent.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery handled?
For a complete claviculectomy on both sides, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does the multiple-procedure reduction affect payment?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.
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.
2,16623106,,Arthrotomy strnclav joint,A,,5.98,7.35,NA,7.35,,1.28,14.61,14.61,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16723107,,Arthrt glenhumrl jt w/expl,A,,8.65,8.30,NA,8.30,,1.80,18.75,18.75,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16823120,,Claviculectomy partial,A,,7.21,8.22,NA,8.22,,1.48,16.91,16.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,16923125,,Claviculectomy total,A,,9.40,8.63,NA,8.63,,2.00,20.03,20.03,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17023130,,Acromp/acromionectomy prtl,A,,7.58,8.52,NA,8.52,,1.59,17.69,17.69,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17123140,,Removal of bone lesion,A,,6.94,7.50,NA,7.50,,1.47,15.91,15.91,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,17223145,,Removal of bone lesion,A,,9.17,8.55,NA,8.55,,1.95,19.67,19.67,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002