Partial excision of the clavicle for bone disease, including craterization, saucerization, or diaphysectomy techniques targeting infected or diseased bone tissue.

Verified May 8, 2026 · 5 sources ↓

Medicare: $654.99
Total RVUs: 19.61
Global, days: 90
Region: Shoulder

Drawn from CMSAAPCGenhealthFastrvu

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Specify the technique used: craterization, saucerization, or diaphysectomy — not just 'partial excision'
Document the diagnosis driving the excision (e.g., osteomyelitis, bone abscess) with a supporting ICD-10 code
If performed with another shoulder procedure, document a separate incision or site entry to support modifier 59
Record the extent of bone removed and whether interior scraping or debridement of the clavicle was performed
Intraoperative pathology or culture results, if obtained, should be referenced in the operative note to substantiate bone disease
Laterality must be specified for LT/RT modifier assignment

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 23180 covers surgical partial removal of the clavicle when bone disease — most commonly osteomyelitis — requires more than simple resection. The technique may involve craterization (creating a crater-shaped defect), saucerization (creating a shallow, dish-shaped cavity), or diaphysectomy (removing a segment of the diaphysis), often combined with interior scraping of the clavicle. This distinguishes 23180 from 23120 (distal clavicle excision), which addresses compression-related pathology such as AC joint arthritis. If the operative report describes only smoothing or rounding off bone without addressing underlying bone disease, 23180 does not apply.

The 90-day global period covers all routine postoperative care through day 90. Unrelated E/M visits in that window need modifier 24; a separately identifiable E/M on the day of surgery needs modifier 25. If the partial excision occurs during the same session as a rotator cuff repair, acromioplasty, or other shoulder procedure, a separate incision or site entry must be documented to support modifier 59 — carriers flag this combination, so the operative note needs to be airtight. Bilateral clavicle procedures are rare but use modifier 50; unilateral procedures should carry LT or RT.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.77
Practice expense RVU	8.98
Malpractice RVU	1.86
Total RVU	19.61
Medicare national rate	$654.99
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$654.99
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI A2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 23180 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Code billed as 23120 when bone disease (not AC joint compression) was the indication — wrong code, not an upgraded one
Modifier 59 missing or unsupported when 23180 billed same-day with rotator cuff repair or acromioplasty without documented separate site entry
Diagnosis code does not support bone disease pathology — osteoarthritis alone won't support 23180
Operative note describes only 'smoothing' or 'contouring' without documenting substantive partial excision for disease treatment
Global period violation: post-op E/M visit billed without modifier 24 when unrelated, or without modifier 25 when same-day pre-procedure

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What's the difference between CPT 23180 and CPT 23120?

23120 is for distal clavicle excision driven by compression pathology like AC joint arthritis. 23180 is for partial excision driven by bone disease — osteomyelitis, abscess, or similar — and often involves interior scraping in addition to resection. Using 23120 when bone disease is the indication is a coding error, not an acceptable alternative.

02Can 23180 and 23120 be billed together?

Not for the same site. If genuinely distinct pathology exists at two different clavicle locations requiring separate procedures, modifier 59 with solid documentation of two distinct sites could apply, but this scenario is uncommon. Check NCCI edits before billing the pair.

03Can 23180 be billed same-day with a rotator cuff repair?

Yes, but only with modifier 59 and only if the operative note documents a separate incision or site entry for the clavicle excision. Carriers scrutinize this combination. If bone was simply smoothed as part of the approach for the rotator cuff repair, 23180 is not separately billable.

04What ICD-10 codes support 23180?

Osteomyelitis of the clavicle (M86 category codes) is the primary driver. Bone abscess is also supportable. Osteoarthritis or AC joint degeneration alone does not support 23180 — those diagnoses point to 23120 instead.

05Does the 90-day global period apply to 23180?

Yes. The global is 090, covering the day before surgery through day 90 post-op. Routine follow-up visits, wound checks, and stitch removals in that window are bundled. Use modifier 24 for unrelated E/M visits and modifier 79 for unrelated procedures performed during the global period.

06Is modifier 22 appropriate for a particularly complex 23180?

Modifier 22 applies when the procedure requires substantially more work than typical — for example, extensive involvement from chronic osteomyelitis requiring prolonged debridement. Document increased time, complexity, or technical difficulty explicitly in the operative note. Without that documentation, payers will deny the upcharge.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the surgical technique by name (craterization, saucerization, or diaphysectomy), the extent of bone removal, whether interior scraping was performed, the confirmed diagnosis of bone disease, and laterality — all from dictation. This prevents the two most common audit flags: operative notes that say 'partial excision' without technique detail, and diagnosis-to-procedure mismatches that trigger medical necessity denials.

See how Mira captures CPT 23180 documentation