CPT code 23630: Humeral fracture repair2026 Medicare rate & RVUs in Oklahoma
Reports open surgical treatment of a fracture of the humeral greater tuberosity, with internal fixation when performed, rather than closed fracture care.
CMS doesn’t publish an office rate for 23630 in Oklahoma.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 23630 covers
An orthopedic surgeon uses an open approach to treat a fracture of the greater tuberosity, the prominence on the upper humerus where rotator cuff tendons attach. Treatment may include exposing and reducing the fracture and securing it with fixation when needed. This code is for the fracture treatment itself; a shoulder dislocation associated with the fracture may point to a different code in the shoulder-dislocation family. Medicare use is concentrated in facility settings.
Select the code when the operative record supports open treatment of the greater tuberosity fracture. Document the fracture location, the open approach, and the treatment performed, including fixation details when applicable. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 bilateral reporting is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
23630 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $684.27 |
How the 23630 rate is calculated
Each of 23630’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 23630
RVUs × geographic indexes × conversion factor
Work10.31
10.31 RVUs× 1.000 GPCI
Practice expense9.56
9.56 RVUs× 1.000 GPCI
Malpractice2.11
2.11 RVUs× 1.000 GPCI
Adjusted RVUs
21.9800
Conversion factor
$33.4009
Medicare rate
$734.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23630
23630 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23630
Humeral fracture repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 23630
Humeral fracture repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
23630 without 50 · national facility
$734.15
Humeral fracture repair
23630-50 · Bilateral: 150%
$1,101.23
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
23630 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 23620Fracture care
- Use 23620 for closed treatment of a greater tuberosity fracture without manipulation; 23630 represents open surgical treatment.
- 23625Fracture treatment
- Code 23625 is closed treatment with manipulation. Choose 23630 when the fracture is treated through an open approach.
- 23665Shoulder reduction
- Code 23665 describes closed treatment of a shoulder dislocation with a greater tuberosity fracture. This code is for open treatment of the fracture rather than that closed dislocation treatment.
- 23670Shoulder surgery
- Code 23670 is for open treatment of a shoulder dislocation with a greater tuberosity fracture; 23630 addresses open treatment of the greater tuberosity fracture itself.
23630 billing questions
When is this code preferable to closed treatment codes 23620 or 23625?
Use 23630 for open surgical treatment of the greater tuberosity fracture. Codes 23620 and 23625 describe closed treatment, with 23625 involving manipulation.
Does the code include internal fixation?
Yes. The code covers open treatment whether or not internal fixation is performed, so fixation is not separately reported as another fracture-treatment service.
What if the greater tuberosity fracture accompanies a shoulder dislocation?
Determine whether the documented procedure treats the fracture alone or treats a shoulder dislocation with the fracture. Codes 23665 and 23670 describe closed and open treatment, respectively, for the dislocation-with-fracture situation.
What documentation supports reporting 23630?
The operative report should identify the greater tuberosity fracture and establish that it was treated through an open approach. Include the reduction and fixation performed, if applicable.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The code also follows the standard multiple-procedure reduction when other procedures are performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons are paid only when supporting documentation is provided; team surgery 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 23630 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →