Summary & Overview
CPT 23575: Closed Treatment of Scapular Fracture
CPT code 23575 denotes the closed treatment of a scapular (shoulder blade) fracture using manipulation and, when needed, skeletal traction without open surgery. This code captures a distinct nonoperative orthopedic procedure that can be performed in acute care settings and outpatient facilities and is relevant to fracture care pathways and bundle-design discussions nationwide.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical scenario that warrants use of CPT code 23575, the typical sites of service where care is delivered, and the procedure’s place in nonoperative fracture management. The publication outlines national benchmarks and utilization context, common billing modifiers and coding considerations, and connections to related orthopedic service lines.
The report serves clinicians, coding professionals, and policy analysts by clarifying clinical intent, coding boundaries, and payer considerations for nonoperative scapular fracture reduction. Data not available in the input is noted where relevant.
Billing Code Overview
CPT code 23575 describes a closed treatment of a scapular fracture. The procedure involves manipulation or adjustment of the fractured scapular bone to achieve reduction without an open surgical approach. Skeletal traction may be applied as part of the reduction when indicated, but no operative fixation is performed.
Service type: Fracture reduction / orthopedic nonoperative procedure
Typical site of service: Hospital outpatient department, emergency department, or ambulatory surgical center where closed fracture management and traction can be performed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who presents to the emergency department or an orthopedic urgent-care clinic after a fall from a height, motor vehicle collision, or direct blow to the shoulder girdle. The patient reports localized scapular pain, swelling, and limited shoulder motion. Initial evaluation includes history, focused physical exam, and plain radiographs (AP, scapular Y, and axillary views). If radiographs confirm a displaced or angulated scapular body or neck fracture that is amenable to nonoperative management, the treating orthopedic surgeon or emergency physician performs a closed treatment under procedural sedation or regional block. The procedure includes manual manipulation and adjustment of the scapular fragments and may include application of skeletal traction or humidified sling/immobilizer to maintain reduction. Post-procedure imaging verifies alignment. The patient is observed for neurovascular stability and pain control, receives activity restrictions, and is scheduled for orthopedic follow-up with repeat imaging to ensure maintained reduction and healing. Typical sites of service are the hospital emergency department, outpatient ambulatory surgery center, or orthopedic clinic procedure room, depending on sedation needs and monitoring requirements.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | When closed treatment is performed on both scapulae during the same encounter |