Summary & Overview
CPT 23505: Closed Treatment of Clavicular Fracture
CPT code 23505 denotes closed treatment of a clavicular fracture — a nonoperative procedure in which the provider manipulates the clavicle to realign bone fragments without surgical incision. This code captures a common acute musculoskeletal intervention performed in emergency settings, urgent care centers, and outpatient orthopedic clinics. Nationally, accurate use of this code matters for appropriate episode reporting, resource allocation, and consistent payment for fracture management.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers can expect a concise review of billing context for closed clavicle reductions, common payer coverage considerations, and the clinical setting where the service is typically provided. The publication outlines typical service lines, expected sites of service, and how CPT code 23505 fits into fracture care pathways. Benchmarks and policy updates are summarized when available; where specific payer policies or local coding guidance are not provided, the text notes data absence.
This overview is intended for clinicians, coding professionals, and policy analysts seeking a national perspective on coding and clinical context for nonoperative clavicular fracture management using CPT code 23505.
Billing Code Overview
CPT code 23505 describes the closed treatment of a clavicular (collarbone) fracture. The procedure involves manipulation or adjustment of the fractured clavicle without open surgery, typically performed to realign bone fragments and restore anatomic position.
Service type: Fracture management / closed reduction
Typical site of service: Emergency department, urgent care, or outpatient orthopedic clinic
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or adolescent who presents to an emergency department, urgent care, or orthopedic clinic after a fall onto the shoulder or outstretched hand with acute clavicle pain, visible deformity, and limited shoulder movement. Evaluation includes focused history, physical exam, and imaging (typically plain radiographs of the clavicle and shoulder). When imaging confirms a midshaft or lateral clavicular fracture appropriate for nonoperative management, the provider performs 23505 for closed treatment with manipulation and realignment under local, regional, or light sedation as clinically indicated. The workflow commonly includes analgesia and possible conscious sedation, closed reduction maneuvers, post-reduction radiographs to confirm alignment, application of a sling or figure-of-eight brace, procedure documentation of reduction method and neurovascular status, and scheduling follow-up within 1–2 weeks for reassessment and repeat imaging.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual anesthesia | When general anesthesia is medically necessary for closed reduction in the absence of a surgical procedure |
50 |