$333.87–$349.56
Both treat a greater tuberosity fracture without open fixation. Choose 23625 when manipulation is performed; choose 23620 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
23625 Fracture treatment Medicare reimbursement rates in New Jersey
Reports closed treatment of a greater tuberosity fracture when the clinician manipulates the fragments to restore alignment without open fixation. Compare 23625 office and facility rates across CMS payment localities in New Jersey.
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 23625 in New Jersey?
New Jersey 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
$482.68–$504.29
2 of 2 localities have a supported rate.
Facility setting
$405.35–$422.16
2 of 2 localities have a supported rate.
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 fracture care
About 23625: Closed reduction of greater tuberosity fracture
Reports closed treatment of a greater tuberosity fracture when the clinician manipulates the fragments to restore alignment without open fixation.
This service treats a fracture of the greater tuberosity of the proximal humerus by manipulating the fragments through the skin to improve alignment, then stabilizing the shoulder as clinically indicated. It is commonly performed by an orthopedic surgeon or other qualified clinician in an office, emergency department, or operating room. The fracture is treated without an incision to expose and fix the bone; traction may be used as part of the closed treatment.
Choose this code when the documented fracture involves the greater tuberosity and the clinician performs manipulation. The record should identify the fracture site, laterality, manipulation performed, and the resulting treatment plan. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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 multiple procedure reduction. For bilateral treatment reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 23625
- 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 RVU4.00 · 30%
- Practice expense (office) RVU8.54 · 64%
- Malpractice RVU0.88 · 7%
135
Medicare services in 2024 · #4636 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.
23625 compared with similar codes
Office rates for New Jersey, from the same CMS release.
$575.56–$601.02
This code is for manipulation of a proximal humeral fracture at the surgical or anatomical neck. 23625 is specific to the greater tuberosity.
No office rate
23630 involves open treatment with internal fixation of a greater tuberosity fracture. 23625 is closed treatment with manipulation.
$536.47–$560.29
23665 describes closed treatment of a shoulder dislocation with an associated greater tuberosity fracture; 23625 addresses the fracture without that dislocation combination.
Compare 23625 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
Northern Nj →
Office / nonfacility
$504.29
Facility
$422.16
Rest Of New Jersey →
Office / nonfacility
$482.68
Facility
$405.35
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23625 billing questions
How does this differ from 23620?
Both address a greater tuberosity fracture treated without open fixation. Use 23625 when the clinician manipulates the fracture fragments; 23620 is the counterpart without manipulation.
When would 23605 be a better fit?
23605 describes closed treatment with manipulation for a proximal humeral fracture at the surgical or anatomical neck. Use 23625 for a greater tuberosity fracture.
Is manipulation required for 23625?
Yes. The record should support active manipulation of the greater tuberosity fracture, not simply immobilization or routine follow-up.
What is included in the global period?
CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported for bilateral treatment?
CMS lists this as a bilateral procedure; when modifier 50 is reported, payment is 150%.
Can an assistant or co-surgeon be paid for this procedure?
CMS lists a statutory restriction on assistant-at-surgery payment. Co-surgeons and team surgery are 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.
2,23423615,,Optx prox humrl fx w/int fix,A,,11.99,10.18,NA,10.18,,2.49,24.66,24.66,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23523616,,Optx prx hmrl fx fix rpr rpl,A,,17.91,11.97,NA,11.97,,3.70,33.58,33.58,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23623620,,Cltx gr hmrl tbrs fx wo mnpj,A,,2.49,6.28,,5.14,,0.50,9.27,8.13,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23723625,,Cltx gr hmrl tbrs fx w/mnpj,A,,4.00,8.54,,6.42,,0.88,13.42,11.30,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23823630,,Optx gr hmrl tbrs fx int fix,A,,10.31,9.56,NA,9.56,,2.11,21.98,21.98,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23923650,,Cltx sho dslc w/mnpj wo anes,A,,3.44,8.73,,6.75,,0.82,12.99,11.01,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24023655,,Cltx sho dslc w/mnpj w/anes,A,,4.64,6.88,NA,6.88,,1.02,12.54,12.54,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00