23125 represents complete clavicle removal. Use 23120 when only part of the clavicle is resected.
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CMS RVU26D · Effective 2026-10-01
23120 Clavicle resection Medicare reimbursement rates in Texas
Report partial claviculectomy when a surgeon removes part of the clavicle, commonly the distal end for persistent acromioclavicular joint symptoms. Compare 23120 office and facility rates across CMS payment localities in Texas.
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 23120 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No 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.
Where 23120 pays more and less in Texas
Orthopedic surgery
About 23120: Partial clavicle resection
Report partial claviculectomy when a surgeon removes part of the clavicle, commonly the distal end for persistent acromioclavicular joint symptoms.
An orthopedic surgeon typically removes a portion of the clavicle during an operative procedure. A common setting is open distal clavicle excision for symptomatic acromioclavicular joint arthritis, sometimes called a Mumford procedure. The operative report should make clear which portion of the clavicle was removed and the clinical reason for the resection.
Select this code for partial clavicle removal, rather than complete clavicle removal or a procedure focused on another bone or a specific lesion. Document the side, operative findings, extent of bone removal, and procedure performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 23120
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.21 · 43%
- Practice expense (office) RVU8.22 · 49%
- Malpractice RVU1.48 · 9%
5.9K
Medicare services in 2024 · #1773 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.
23120 compared with similar codes
Office rates for Texas, from the same CMS release.
23180 describes specified partial bone-excision techniques, including craterization or saucerization. 23120 is the partial claviculectomy code for resection such as distal clavicle excision.
23170 is for clavicular sequestrum removal. Use 23120 for partial clavicle resection when the procedure is not specifically a sequestrectomy.
23130 addresses partial acromion removal or acromioplasty; 23120 removes part of the clavicle.
Compare 23120 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $575.58 |
| Beaumont | Office Unavailable | Facility $536.59 |
| Brazoria | Office Unavailable | Facility $553.39 |
| Dallas | Office Unavailable | Facility $558.86 |
| Fort Worth | Office Unavailable | Facility $556.76 |
| Galveston | Office Unavailable | Facility $556.31 |
| Houston | Office Unavailable | Facility $583.40 |
| Rest Of Texas | Office Unavailable | Facility $546.01 |
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23120 billing questions
When is partial claviculectomy used instead of complete claviculectomy?
Use this code when the surgeon removes only part of the clavicle. Complete removal is reported with 23125.
Is distal clavicle excision for acromioclavicular joint arthritis a typical example?
Yes. Partial removal of the distal clavicle for symptomatic acromioclavicular joint disease is a common example.
How should bilateral partial claviculectomy be reported?
CMS specifies modifier 50 for a bilateral procedure, paid at 150%. The operative documentation should support treatment of both sides.
What happens when other procedures are performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
What documentation supports this code?
The operative report should identify the side, the reason for surgery, and the portion and extent of clavicle removed.
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.
