Billing code 23570: Scapular fracture careMedicare rate & RVUs in Oregon
Reports closed, nonoperative management of a scapular fracture when the treating clinician accepts alignment without manipulating the fracture.
Medicare pays $260.52–$282.32 for 23570 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 23570 covers
An orthopedic surgeon or other physician managing a scapular fracture may report this service when treatment is closed and alignment is accepted without manipulation. Care may include clinical assessment, nonoperative immobilization such as a sling when appropriate, and management of healing. The record should identify the fracture site and support that the clinician is assuming fracture care, rather than only evaluating the injury before referral. Treatment may occur in an office or hospital setting.
Document the fracture site and pattern, the closed approach, the decision not to manipulate, and the care plan. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral treatment with modifier 50 is paid at 150%. Assistant-at-surgery services are subject to a statutory payment restriction; 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 23570 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $282.32 | $267.85 |
| Rest Of Oregon | $260.52 | $247.54 |
How the 23570 rate is calculated
Each of 23570’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 · 23570
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.30Practice expense 5.19Malpractice 0.47
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23570
23570 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23570
Scapular fracture care
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 23570
Scapular fracture care
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
23570 without 50 · national office
$265.87
Scapular fracture care
23570-50 · Bilateral: 150%
$398.81
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).
23570 compared with similar codes
Compare codes
23570 vs 23575 vs 23585 vs 23500: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23575Scapula fracture
- Both describe closed treatment of a scapular fracture; 23575 is the choice when manipulation is performed, while 23570 is for treatment without manipulation.
- 23585Scapular fracture repair
- Choose 23585 when the scapular fracture is treated through an open approach with internal fixation; 23570 describes closed treatment without manipulation.
- 23500Clavicle fracture care
- 23500 is for closed treatment without manipulation of a clavicular fracture. Confirm whether the fractured bone is the clavicle or the scapula.
23570 billing questions
When should 23570 be chosen over 23575?
Report 23570 when the scapular fracture is treated closed without manipulation. Use 23575 when the clinician manipulates the fracture as part of closed treatment.
How does 23570 differ from 23585?
23570 describes closed treatment without manipulation. 23585 is for open treatment of a scapular fracture with internal fixation.
Does applying a sling alone support 23570?
The documentation should show that the clinician assumed fracture care and selected closed treatment without manipulation. A sling application by itself does not establish those facts.
Are related follow-up visits included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be paid for this service?
CMS applies a statutory restriction to 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 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
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