23600 Fracture care Medicare reimbursement rates in Utah

CPT 23600 represents definitive closed fracture care for a proximal humerus fracture when the clinician treats it without manipulating the fragments. Typical cases involve fractures managed with a sling or shoulder immobilizer rather than reduction, after imaging confirms the injury. Orthopedic surgeons, emergency physicians, or other clinicians may provide the initial care in an office, emergency department, or hospital setting.

Select this code based on the fracture location and treatment performed: the fracture involves the proximal humerus, is treated closed, and is not manipulated. Documentation should support the fracture diagnosis, affected side, imaging findings, and treatment plan, including that no manipulation was performed. Medicare assigns a 90-day major-surgery global period; the day-before preoperative visit and related postoperative care during that period are included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.