Billing code 23500: Clavicle fracture careMedicare rate & RVUs in Texas
Reports nonoperative definitive care of a clavicle fracture when the clinician treats it without manipulating or manually repositioning the fracture fragments.
Medicare pays $241.70–$266.56 for 23500 in the office in Texas, from Beaumont to Austin. 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 23500 covers
This service covers nonoperative management of a clavicle fracture without manually repositioning the fragments. Care may include assessing alignment, choosing support such as a sling, and providing activity restrictions and follow-up instructions. Orthopedic clinicians commonly provide the treatment in an outpatient clinic or emergency setting, or after referral from another clinician.
Report 23500 when the record supports definitive closed fracture care without manipulation, rather than evaluation alone. Document the affected clavicle, fracture diagnosis, treatment undertaken, and plan for immobilization and monitoring. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care. For procedures performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral treatment reported with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; 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 23500 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$241.70 to $266.56
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $266.56 | $252.78 |
| Beaumont | $241.70 | $229.85 |
| Brazoria | $253.91 | $241.01 |
| Dallas | $256.02 | $243.04 |
| Fort Worth | $254.50 | $241.65 |
| Galveston | $254.98 | $242.04 |
| Houston | $263.22 | $250.28 |
| Rest Of Texas | $247.99 | $235.63 |
How the 23500 rate is calculated
Each of 23500’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 · 23500
RVUs × geographic indexes × conversion factor
Work2.15
2.15 RVUs× 1.000 GPCI
Practice expense5.13
5.13 RVUs× 1.000 GPCI
Malpractice0.45
0.45 RVUs× 1.000 GPCI
Adjusted RVUs
7.7300
Conversion factor
$33.4009
Medicare rate
$258.19
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23500
23500 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23500
Clavicle 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 · 23500
Clavicle 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
23500 without 50 · national office
$258.19
Clavicle fracture care
23500-50 · Bilateral: 150%
$387.29
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).
23500 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23505Clavicle fracture
- Both codes cover closed clavicle fracture care; 23505 is for treatment that includes manipulation, while 23500 is for treatment without it.
- 23515Clavicle fracture repair
- Use 23515 when the clavicle fracture is treated operatively with internal fixation, rather than by closed care without manipulation.
- 23540AC joint dislocation
- 23540 addresses closed treatment of an acromioclavicular dislocation, not a fracture of the clavicle.
23500 billing questions
When should 23500 be chosen over 23505?
Use 23500 when definitive closed care is provided without manipulating the fracture. Use 23505 when the clinician manipulates the fracture.
Can the evaluation visit be billed separately?
The CMS 90-day global period includes the day-before preoperative visit and related postoperative care. Do not separately report routine care included in that global period.
How is treatment of both clavicles reported?
When both sides are treated, modifier 50 identifies the bilateral procedure; CMS pays it at 150%.
Is an assistant surgeon payable for this service?
No. CMS lists a statutory restriction on assistant-at-surgery payment for this code.
What documentation supports reporting 23500?
Document the clavicle fracture, the side treated, and the definitive closed treatment performed without manipulation, along with the immobilization and follow-up plan.
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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