Summary & Overview
CPT 23480: Clavicle Osteotomy or Open Clavicular Reconstruction
CPT code 23480 denotes an open surgical procedure on the clavicle to correct poor alignment, repair fractures, alter bone length, or treat arthritis-related damage; internal fixation with implants may be performed during the operation. This code is nationally relevant because clavicular surgeries are common in trauma and orthopedic practice and involve inpatient or ambulatory surgical resources, implants, and post-operative care pathways that affect payer coverage and utilization patterns. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing context for CPT code 23480, including typical sites of service and the service type, plus an overview of payer coverage considerations and common modifiers used with this procedure. The publication also outlines benchmarks and policy updates relevant to surgical clavicle procedures, practical billing guidance items (such as use of implant-related reporting), and clinical context that clarifies when the code applies. Data not available in the input is noted where specific benchmarking, associated taxonomies, ICD-10 pairings, and related codes would normally appear.
Billing Code Overview
CPT code 23480 describes a surgical procedure on the clavicle (collar bone) in which the surgeon incises and surgically alters a portion of the clavicle to correct malalignment, treat fractures, shorten or lengthen the bone, or address degenerative changes such as arthritis. The description notes that the provider may perform internal fixation with implants as part of the procedure.
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Service type: Orthopedic surgical procedure involving operative clavicular osteotomy and/or open treatment of clavicular deformity or fracture.
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Typical site of service: Hospital operating room or ambulatory surgical center, performed by an orthopedic surgeon or trauma surgeon.
Clinical & Coding Specifications
Clinical Context
A 45-year-old construction worker presents with a displaced midshaft clavicle fracture after a fall from a ladder. He reports severe shoulder pain, visible deformity of the clavicle, and limited shoulder range of motion. Initial evaluation in the emergency department includes neurovascular exam, shoulder radiographs, and pain control. Conservative management is considered, but radiographs demonstrate significant shortening and displacement with skin tenting. After shared decision-making, the patient is scheduled for open reduction and internal fixation of the clavicle.
On the day of surgery the patient undergoes general anesthesia in an ambulatory surgical center or hospital operating room. The surgeon makes an incision over the clavicle, performs exposure and debridement, reduces the fracture, and applies internal fixation (plate and screws). Intraoperative fluoroscopy is used to confirm reduction and hardware position. Estimated blood loss is minimal. The patient is taken to recovery, discharged with pain control and sling immobilization, and given follow-up for wound check and progressive rehabilitation. Typical sites of service include the hospital operating room or ambulatory surgical center. Typical service type is surgical – orthopedic open reduction internal fixation of the clavicle using implants.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time substantially greater than typical for the procedure due to technical difficulty (document rationale). |