Choose 23605 when closed treatment includes manipulation, with or without traction. Choose 23600 when the fracture is treated without manipulation.
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CMS RVU26D · Effective 2026-10-01
23600 Fracture care Medicare reimbursement rates in Washington
Reports definitive closed care of a proximal humerus fracture when the clinician manages the fracture without manipulating the bone fragments. Compare 23600 office and facility rates across CMS payment localities in Washington.
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 23600 in Washington?
Washington has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$391.44–$441.94
2 of 2 localities have a supported rate.
Facility setting
$339.74–$381.69
2 of 2 localities have a supported rate.
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 23600: Proximal humerus fracture care without manipulation
Reports definitive closed care of a proximal humerus fracture when the clinician manages the fracture without manipulating the bone fragments.
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.
CMS billing rules for 23600
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.93 · 26%
- Practice expense (office) RVU7.87 · 69%
- Malpractice RVU0.61 · 5%
25.3K
Medicare services in 2024 · #1046 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.
23600 compared with similar codes
Office rates for Washington, from the same CMS release.
23615 describes open treatment with internal fixation. 23600 is for closed care without manipulation.
23620 is specific to a greater tuberosity fracture treated without manipulation; 23600 covers closed care of a proximal humerus fracture without manipulation.
Compare 23600 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.
2 of 2 payment localities
Rest Of Washington →
Office / nonfacility
$391.44
Facility
$339.74
Seattle (King Cnty) →
Office / nonfacility
$441.94
Facility
$381.69
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23600 billing questions
When should 23600 be chosen instead of 23605?
Use 23600 when the proximal humerus fracture is treated without manipulating the fragments. Code 23605 describes closed treatment that includes manipulation, with or without traction.
Are routine fracture follow-up visits included?
Related postoperative care during the 90-day global period is included, along with the day-before preoperative visit.
Can modifier 50 be reported when both shoulders are treated?
Yes. CMS classifies this as a bilateral procedure; modifier 50 is paid at 150%.
How does Medicare handle an assistant or co-surgeon?
An assistant at surgery is not paid for this service. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
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.
