$258.12
Both codes describe closed treatment of a sternoclavicular dislocation. Choose 23525 when manipulation is performed; 23520 is for treatment without manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
23525 Joint reduction Medicare reimbursement rates in Utah
Orthopedic closed reduction of a sternoclavicular dislocation with manipulation, reported when the joint is restored without open exposure or fixation. Compare 23525 office and facility rates across CMS payment localities in Utah.
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 23525 in Utah?
Utah 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
$425.77
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
$351.36
1 of 1 localities have a supported rate.
Payment area: Utah
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 treatment
About 23525: Closed reduction of sternoclavicular dislocation
Orthopedic closed reduction of a sternoclavicular dislocation with manipulation, reported when the joint is restored without open exposure or fixation.
Code 23525 describes closed treatment of a sternoclavicular joint dislocation in which the clinician manipulates the clavicle and sternum to restore alignment without surgically exposing the joint. An orthopedic surgeon typically performs the reduction. Posterior displacement may require urgent attention because of the sternoclavicular joint’s proximity to mediastinal structures. This code is specific to the sternoclavicular articulation, not the acromioclavicular joint or a clavicle fracture.
Report 23525 when the record supports an actual closed reduction with manipulation, rather than closed treatment without manipulation (23520) or open treatment. Document the dislocation, side, reduction maneuver, and post-reduction alignment. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%; bilateral reporting with modifier 50 is paid at 150%. An assistant is payable only with documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 23525
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.70 · 28%
- Practice expense (office) RVU8.87 · 66%
- Malpractice RVU0.79 · 6%
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.
23525 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
23530 is for open treatment of a sternoclavicular dislocation. Use 23525 when the reduction is performed closed, without open exposure.
No office rate
23532 describes open sternoclavicular dislocation treatment with a graft. It does not describe a closed reduction with manipulation.
$477.42
23545 is closed treatment with manipulation of an acromioclavicular dislocation. Code 23525 applies to the sternoclavicular joint.
Compare 23525 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
Utah →
Office / nonfacility
$425.77
Facility
$351.36
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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 23525 in Utah.
PPRRVU2026_Oct_nonQPP.csv
2,222
- Code
- 23525
- Physician work
- 3.70
- Practice expense
- 8.87
- Malpractice
- 0.79
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.70 | × 1.000 | 3.7000 |
| Practice expense | 8.87 | × 0.940 | 8.3378 |
| Malpractice | 0.79 | × 0.898 | 0.7094 |
| Total RVUs | 12.7472 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$425.77
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.7 | 1 |
| Practice expense | 8.87 | 0.94 |
| Malpractice | 0.79 | 0.898 |
(3.7 × 1 + 8.87 × 0.94 + 0.79 × 0.898) × $33.4009 = $425.77
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.7 | 1 |
| Practice expense | 6.5 | 0.94 |
| Malpractice | 0.79 | 0.898 |
(3.7 × 1 + 6.5 × 0.94 + 0.79 × 0.898) × $33.4009 = $351.36
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.
23525 billing questions
When should 23525 be chosen over 23520?
Use 23525 when the clinician manipulates the dislocated sternoclavicular joint to restore alignment. Use 23520 for closed treatment without manipulation.
How does 23525 differ from 23530?
23525 describes closed treatment with manipulation. 23530 describes open treatment of a sternoclavicular dislocation.
Is manipulation separately reported?
The manipulation is part of the closed treatment represented by 23525; it is not separately reported as another reduction service for the same dislocation.
What documentation supports 23525?
Document the sternoclavicular dislocation, the affected side, the closed manipulation performed, and the resulting alignment. The record should make clear that the joint was treated by manipulation rather than open exposure.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. CMS also applies the standard multiple-procedure reduction 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 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.
2,21923505,,Cltx clavicular fx w/mnpj,A,,3.73,7.70,,5.80,,0.81,12.24,10.34,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22023515,,Optx clavicular fx w/int fix,A,,9.45,8.94,NA,8.94,,1.94,20.33,20.33,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22123520,,Cltx strnclav dislc w/o mnpj,A,,2.23,5.40,,4.68,,0.47,8.10,7.38,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22223525,,Cltx strnclav dislc w/mnpj,A,,3.70,8.87,,6.50,,0.79,13.36,10.99,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22323530,,Optx strnclav dislc aqt/chrn,A,,7.29,7.61,NA,7.61,,1.54,16.44,16.44,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22423532,,Optx strclv dslc aq/chrn grf,A,,8.00,8.18,NA,8.18,,1.70,17.88,17.88,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22523540,,Cltx acromclav dislc wo mnpj,A,,2.30,5.49,,4.90,,0.49,8.28,7.69,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985