$468.00
Both describe closed treatment of a scapular fracture; 23575 is the choice when manipulation is performed, while 23570 is for treatment without manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
23570 Scapular fracture care Medicare reimbursement rates in Rhode Island
Reports closed, nonoperative management of a scapular fracture when the treating clinician accepts alignment without manipulating the fracture. Compare 23570 office and facility rates across CMS payment localities in Rhode Island.
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 23570 in Rhode Island?
Rhode Island 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
$271.36
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$257.90
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 fracture care
About 23570: Closed scapular fracture treatment without manipulation
Reports closed, nonoperative management of a scapular fracture when the treating clinician accepts alignment without manipulating the fracture.
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.
CMS billing rules for 23570
- 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 RVU2.30 · 29%
- Practice expense (office) RVU5.19 · 65%
- Malpractice RVU0.47 · 6%
2.4K
Medicare services in 2024 · #2314 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.
23570 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
Choose 23585 when the scapular fracture is treated through an open approach with internal fixation; 23570 describes closed treatment without manipulation.
$263.58
23500 is for closed treatment without manipulation of a clavicular fracture. Confirm whether the fractured bone is the clavicle or the scapula.
Compare 23570 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
Rhode Island →
Office / nonfacility
$271.36
Facility
$257.90
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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 23570 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,229
- Code
- 23570
- Physician work
- 2.30
- Practice expense
- 5.19
- Malpractice
- 0.47
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.30 | × 1.019 | 2.3437 |
| Practice expense | 5.19 | × 1.033 | 5.3613 |
| Malpractice | 0.47 | × 0.892 | 0.4192 |
| Total RVUs | 8.1242 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$271.36
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.3 | 1.019 |
| Practice expense | 5.19 | 1.033 |
| Malpractice | 0.47 | 0.892 |
(2.3 × 1.019 + 5.19 × 1.033 + 0.47 × 0.892) × $33.4009 = $271.36
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.3 | 1.019 |
| Practice expense | 4.8 | 1.033 |
| Malpractice | 0.47 | 0.892 |
(2.3 × 1.019 + 4.8 × 1.033 + 0.47 × 0.892) × $33.4009 = $257.90
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.
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 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.
2,22623545,,Cltx acromclav dislc w/mnpj,A,,3.34,10.86,,8.59,,0.83,15.03,12.76,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22723550,,Optx acromclv dislc aqt/chrn,A,,7.40,7.33,NA,7.33,,1.46,16.19,16.19,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22823552,,Optx acrclv dslc aq/chrn grf,A,,8.60,8.04,NA,8.04,,1.69,18.33,18.33,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22923570,,Cltx scapular fx w/o mnpj,A,,2.30,5.19,,4.80,,0.47,7.96,7.57,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23023575,,Cltx scap fx w/mnpj +-tractj,A,,4.12,8.74,,6.35,,0.88,13.74,11.35,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23123585,,Optx scapular fx w/int fixj,A,,13.87,10.12,NA,10.12,,2.82,26.81,26.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23223600,,Cltx prox humrl fx w/o mnpj,A,,2.93,7.87,,6.40,,0.61,11.41,9.94,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537