CPT code 23485: Clavicle osteotomy2026 Medicare rate & RVUs in Virginia
Report this service when a surgeon corrects clavicular alignment with an osteotomy and uses bone graft as part of the reconstruction.
CMS doesn’t publish an office rate for 23485 in Virginia.
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 23485 covers
An orthopedic surgeon uses this service to correct a clavicle deformity or difficult healing problem by cutting and repositioning the bone and incorporating bone graft. A typical setting is the operating room, such as surgery to address a symptomatic clavicle malunion where correction requires graft support. The operative record should make clear that the clavicle was osteotomized and bone graft was used; a graft-only procedure or reinforcement without corrective osteotomy is a different service.
Select this code when the documented work includes both the clavicular osteotomy and graft, rather than the osteotomy service without graft. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 identifies bilateral work, paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. CMS does not permit team-surgery payment for this service.
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 23485 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $964.39 |
| Virginia | Unavailable | $838.78 |
How the 23485 rate is calculated
Each of 23485’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 · 23485
RVUs × geographic indexes × conversion factor
Work13.56
13.56 RVUs× 1.000 GPCI
Practice expense9.77
9.77 RVUs× 1.000 GPCI
Malpractice2.76
2.76 RVUs× 1.000 GPCI
Adjusted RVUs
26.0900
Conversion factor
$33.4009
Medicare rate
$871.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23485
23485 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23485
Clavicle osteotomy
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 23485
Clavicle osteotomy
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
23485 without 50 · national facility
$871.43
Clavicle osteotomy
23485-50 · Bilateral: 150%
$1,307.14
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).
23485 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 23480Clavicle osteotomy
- Choose 23485 when bone graft is used with the clavicular osteotomy. Choose 23480 for the osteotomy without that graft distinction.
- 23490Clavicle reinforcement
- 23490 describes reinforcement of the clavicle. This code represents corrective clavicular osteotomy with bone graft, not reinforcement alone.
- 23491Scapular stabilization
- 23491 concerns reinforcement of shoulder bones. Use 23485 when the documented service is a clavicular osteotomy performed with bone graft.
23485 billing questions
How does this differ from 23480?
23485 is for clavicular osteotomy with bone graft. Use 23480 when the osteotomy is performed without the graft distinction.
Is the bone graft part of this service?
Yes. The code identifies a clavicular osteotomy performed with bone graft, so documentation should support both the osteotomy and graft use.
Does the 90-day global include postoperative visits?
It includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral work reported?
Use modifier 50 for bilateral work; CMS payment for this code is at 150%.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team-surgery payment is 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 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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