Billing code 23520: Sternoclavicular treatmentMedicare rate & RVUs in Oregon
Reports closed care of a sternoclavicular joint dislocation when the provider treats the injury without manipulating the joint to reduce it.
Medicare pays $265.16–$287.74 for 23520 in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.
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 23520 covers
This code describes closed treatment of a dislocation where the clavicle meets the sternum, without manipulation of the joint. An orthopedic surgeon or other qualified treating provider may manage the injury with measures such as a sling, activity restrictions, and clinical follow-up. It applies to the sternoclavicular joint, not the acromioclavicular joint at the outer end of the clavicle. The code reflects definitive treatment, rather than simply identifying the injury during an evaluation.
Choose this code when the documented treatment is closed and no manipulation is performed; use the related with-manipulation code when the provider manipulates the joint. Documentation should identify the sternoclavicular dislocation and support the treatment approach. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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.
Where 23520 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $287.74 | $261.02 |
| Rest Of Oregon | $265.16 | $241.21 |
How the 23520 rate is calculated
Each of 23520’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 · 23520
RVUs × geographic indexes × conversion factor
Work2.23
2.23 RVUs× 1.000 GPCI
Practice expense5.40
5.40 RVUs× 1.000 GPCI
Malpractice0.47
0.47 RVUs× 1.000 GPCI
Adjusted RVUs
8.1000
Conversion factor
$33.4009
Medicare rate
$270.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23520
23520 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23520
Sternoclavicular treatment
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 23520
Sternoclavicular treatment
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
23520 without 50 · national office
$270.55
Sternoclavicular treatment
23520-50 · Bilateral: 150%
$405.83
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).
23520 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 23525Joint reduction
- Both describe closed treatment of a sternoclavicular dislocation. Use 23520 without manipulation and 23525 when the provider manipulates the joint.
- 23530Joint dislocation surgery
- 23530 is for open treatment of a sternoclavicular dislocation; 23520 is closed treatment without manipulation.
- 23540AC joint dislocation
- 23540 treats a dislocation at the acromioclavicular joint, near the shoulder, rather than the sternoclavicular joint treated by 23520.
- 23500Clavicle fracture care
- 23500 concerns closed treatment of a clavicular fracture. 23520 concerns a dislocation at the sternoclavicular joint.
23520 billing questions
When should 23520 be chosen instead of 23525?
Report 23520 when the sternoclavicular dislocation is treated closed without manipulation. Choose 23525 when the provider manipulates the joint as part of closed treatment.
How does 23520 differ from open treatment?
23520 describes closed treatment without manipulation. When the provider surgically treats the sternoclavicular dislocation, consider the applicable open-treatment code, such as 23530 or 23532.
What documentation supports reporting 23520?
Document the sternoclavicular joint dislocation, the closed treatment plan, and that the joint was not manipulated. Include the treatment provided, such as immobilization or activity restrictions, when applicable.
What is included in the global period?
CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported?
For bilateral treatment, CMS pays modifier 50 at 150%. The code's multiple-procedure reduction also applies when other procedures are performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.
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 23520 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 →