Summary & Overview
CPT 23500: Closed Treatment of Clavicular Fracture
CPT code 23500 covers the closed, nonoperative treatment of clavicular (collarbone) fractures. Nationally, this code captures routine orthopedic management when the fracture does not require manipulation or surgical intervention. It matters for hospitals, outpatient orthopedic clinics, and emergency departments because it defines billing for conservative fracture care that often follows imaging and clinical assessment but stops short of operative fixation.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, plus what to expect in payer coverage patterns and reimbursement benchmarks. The publication outlines common billing considerations for nonoperative clavicle fracture care, clarifies where CPT code 23500 applies in care pathways, and highlights data gaps where information was not provided.
This resource is intended for coding professionals, practice managers, and policy analysts seeking a national perspective on billing and coverage for conservative clavicular fracture treatment under CPT code 23500. Data not available in the input is noted where relevant.
Billing Code Overview
CPT code 23500 describes the closed treatment of a clavicular (collarbone) fracture. The procedure involves nonoperative management without manipulation or surgical incision; the provider delivers fracture care through external measures only.
-
Service type: Closed fracture treatment, nonoperative orthopedic care
-
Typical site of service: Emergency department, urgent care, or outpatient orthopedic clinic
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to the emergency department after a bicycle collision with localized pain, swelling, and tenderness over the midshaft of the right clavicle. Plain radiographs confirm a non-displaced midshaft clavicular fracture without neurovascular compromise. The treating emergency physician or orthopedic provider performs a closed treatment consisting of immobilization with a sling or figure-of-eight bandage, wound care if needed, oral analgesics, and instructions for activity restriction and follow-up. No manipulation under anesthesia, open reduction, or internal fixation is performed. Typical workflow includes initial triage and assessment, radiographic confirmation, analgesia and immobilization, patient education and discharge with outpatient orthopedic follow-up within one to two weeks. Typical site of service is the emergency department, urgent care clinic, or outpatient orthopedic clinic for nonoperative management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when a separate E/M is medically necessary and documented in addition to the closed treatment procedural service. |
52 |