Summary & Overview
CPT 23515: Open Treatment of Clavicle Fracture
CPT code 23515 denotes open surgical treatment of a clavicle (collar bone) fracture, often involving internal fixation with pins or screws. This operative procedure is a common orthopedic intervention for displaced clavicle fractures and is relevant to hospitals, ambulatory surgery centers, and orthopedic practices nationwide. It has implications for surgical resource use, inpatient versus outpatient settings, and device utilization.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, an overview of typical sites of service and service type, and information useful for coding and billing teams, revenue cycle managers, and clinical leaders.
The report outlines national benchmarks where available, summarizes common billing considerations, and highlights the clinical setting in which 23515 is used. It is intended to help clinical and administrative stakeholders understand where this code fits within orthopedic surgical care pathways and payer coverage landscapes. Data not available in the input will be noted where relevant.
Billing Code Overview
CPT code 23515 describes an open treatment of a clavicle (collar bone) fracture. The procedure typically involves surgical exposure of the clavicle and may include internal fixation using implants such as pins or screws to align and stabilize the fracture.
Service type: Surgical — Orthopedic open fracture fixation
Typical site of service: Operating room / inpatient or outpatient surgical facility, including hospital surgical suites and ambulatory surgery centers.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents to the emergency department after a bicycle collision with localized pain, deformity, and limited shoulder range of motion. Radiographs and CT show a displaced midshaft clavicle fracture with shortening and segmental comminution. Nonoperative management is unlikely to restore alignment. The orthopedic trauma surgeon schedules an open reduction and internal fixation of the clavicle with plate and screws. The procedure is performed in the hospital operating room under general anesthesia with regional nerve block for postoperative analgesia. Intraoperative steps include open exposure of the fracture, anatomic reduction, provisional fixation with Kirschner wires if needed, definitive fixation using a precontoured clavicle plate and cortical screws, intraoperative fluoroscopy to confirm reduction and hardware position, wound irrigation, hemostasis, and layered closure. Postoperative care includes pain control, sling immobilization, wound checks, and radiographic follow-up to assess healing. Rehabilitation with progressive range-of-motion and strengthening begins per surgeon protocol once radiographic healing is evident.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the open clavicle fixation requires substantially greater effort, time, or complexity than usual (extensive comminution, significant soft-tissue work). |