$256.38
Both describe closed scapular fracture treatment. Choose 23575 when manipulation is performed; 23570 applies when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
23575 Scapula fracture Medicare reimbursement rates in Vermont
Reports closed treatment of a scapular fracture when the physician manipulates the fracture, with or without skeletal traction, to achieve reduction. Compare 23575 office and facility rates across CMS payment localities in Vermont.
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 23575 in Vermont?
Vermont 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
$441.49
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$362.46
1 of 1 localities have a supported rate.
Payment area: Vermont
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 23575: Closed scapular fracture treatment with manipulation
Reports closed treatment of a scapular fracture when the physician manipulates the fracture, with or without skeletal traction, to achieve reduction.
This service covers closed treatment of a scapular fracture when the physician manipulates the fragments to improve alignment, with or without skeletal traction. An orthopedic surgeon or other qualified physician may provide it after trauma involving the scapular body, neck, or glenoid region. Treatment is performed without surgically exposing the fracture; the clinical setting depends on the injury and the reduction required.
Report the code when the treatment includes manipulation, not for closed care without manipulation. The record should identify the scapular fracture and document the reduction and any traction used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 indicates bilateral treatment and is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 23575
- 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 RVU4.12 · 30%
- Practice expense (office) RVU8.74 · 64%
- Malpractice RVU0.88 · 6%
73
Medicare services in 2024 · #5114 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.
23575 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Use 23585 for open treatment of a scapular fracture, including internal fixation when performed. Use 23575 for closed treatment with manipulation.
$392.89
Code 23505 is for closed treatment with manipulation of a clavicular fracture. Code 23575 is for a scapular fracture.
Compare 23575 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
Vermont →
Office / nonfacility
$441.49
Facility
$362.46
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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 23575 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,230
- Code
- 23575
- Physician work
- 4.12
- Practice expense
- 8.74
- Malpractice
- 0.88
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.12 | × 1.000 | 4.1200 |
| Practice expense | 8.74 | × 0.990 | 8.6526 |
| Malpractice | 0.88 | × 0.506 | 0.4453 |
| Total RVUs | 13.2179 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$441.49
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.12 | 1 |
| Practice expense | 8.74 | 0.99 |
| Malpractice | 0.88 | 0.506 |
(4.12 × 1 + 8.74 × 0.99 + 0.88 × 0.506) × $33.4009 = $441.49
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.12 | 1 |
| Practice expense | 6.35 | 0.99 |
| Malpractice | 0.88 | 0.506 |
(4.12 × 1 + 6.35 × 0.99 + 0.88 × 0.506) × $33.4009 = $362.46
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.
23575 billing questions
How does this differ from 23570?
Use 23575 when closed scapular fracture treatment includes manipulation, with or without skeletal traction. Code 23570 is for closed treatment without manipulation.
When is 23585 the better choice?
Code 23585 describes open treatment of a scapular fracture, including internal fixation when performed. This code is for closed treatment with manipulation.
Does the code include related postoperative visits?
Yes. Its 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported?
Report modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.
Can an assistant surgeon be paid?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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.
2,22723550,,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
2,23323605,,Cltx prx hmrl fx mnpj+-tract,A,,4.93,10.00,,7.19,,1.08,16.01,13.20,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817