Surgical cutting and realignment of the clavicle, with or without internal fixation using plates or screws.

Verified May 8, 2026 · 5 sources ↓

Medicare: $763.88
Total RVUs: 22.87
Global, days: 90
Region: Shoulder

Drawn from AAPCJnjmedtechGenhealthCMS

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Explicit documentation of osteotomy — the word 'osteotomy' or a clear description of bone cutting and repositioning must appear in the operative note
Surgical approach and incision location over the clavicle
Whether internal fixation was used, including implant type (plate, screws) and configuration
Indication for procedure: malunion, deformity, arthritis, congenital abnormality, or prior fracture with malalignment
Laterality — left or right clavicle — stated explicitly in the operative report
If bone graft was used, document graft type and source; if so, consider 23485 instead of 23480

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 57 Decision for surgery 58 Staged or related 59 Distinct service 62 Co-surgeons 73 Discontinued pre-anesthesia 74 Discontinued post-anesthesia 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 23480 covers an open osteotomy of the clavicle — the surgeon cuts the collarbone and repositions it to correct malunion, poor alignment, shortening, lengthening, or arthritic damage. Internal fixation with plates or screws may be added within the same code; no separate implant placement code is needed. The procedure carries a 90-day global period, covering all routine post-op care through day 90.

The single most important coding rule for 23480: osteotomy must be explicitly documented in the operative note. Use of a rongeur or curette alone does not constitute an osteotomy. If the surgeon performed open reduction and internal fixation for a clavicle fracture without a planned bone cut and reposition, report 23515 instead. If bone graft was used for nonunion or malunion, step up to 23485, which bundles graft harvest and fixation.

This code sits in the shoulder repair and reconstruction section. It is not arthroscopic — open approach is required. Laterality modifiers (LT/RT) apply when the operative note specifies the side, and modifier 22 is appropriate when significantly increased complexity is documented, such as a revision after prior hardware failure with extensive scarring.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	11.25
Practice expense RVU	9.22
Malpractice RVU	2.4
Total RVU	22.87
Medicare national rate	$763.88
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	$763.88
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 23480 get rejected.

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

Osteotomy not documented — rongeur or curette use in the operative note does not support 23480; payers downcode or deny without an explicit bone-cutting and realignment description
Wrong code selected — open ORIF for acute clavicle fracture billed as 23480 instead of 23515
Missing laterality modifier when payer requires LT or RT for shoulder procedures
23480 billed when bone graft was used for nonunion or malunion — should be 23485
Modifier 22 applied without supporting documentation of increased complexity or operative time

Frequently asked questions

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

01Can I bill 23480 when the surgeon used a rongeur and curette on the clavicle?

No. Rongeur and curette use does not document an osteotomy. Report 23480 only when the operative note explicitly describes cutting and repositioning the clavicle. If the procedure was open ORIF for a fracture, report 23515.

02When should I use 23485 instead of 23480?

Use 23485 when the osteotomy is performed for nonunion or malunion and bone graft is used. Code 23485 bundles graft harvest and necessary fixation, so do not separately report graft harvest. 23480 is appropriate when no bone graft is needed.

03Does internal fixation change the code?

No. Internal fixation is described within 23480 ('with or without internal fixation'). Whether or not plates or screws are placed, the code remains 23480. Do not separately bill a fixation code.

04What global period applies to 23480?

23480 carries a 90-day global period. Routine follow-up visits, dressing changes, and stitch removal through day 90 are included. Bill unrelated E/M services in the global window with modifier 24; related E/M on the same day as surgery requires modifier 25.

05Are laterality modifiers required for 23480?

Medicare does not require LT/RT for clavicle codes the way it does for paired limb procedures, but many commercial payers do. Append LT or RT when the payer requires it and laterality is stated in the operative note. Omitting laterality when required is a common reason for requests for additional information.

06Can 23480 be billed with arthroscopic shoulder codes on the same day?

23480 is an open procedure. If arthroscopic work was performed on the same shoulder in the same session, append modifier 59 (or the appropriate X modifier) to the secondary code to indicate a distinct procedural service, and verify NCCI edits for the specific combination.

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 surgeon's dictated description of the bone cut, realignment technique, fixation hardware used, and the clinical indication (malunion, deformity, or arthritic damage) directly from the operative narrative. That documentation locks in the osteotomy language auditors require to support 23480 and prevents downcoding to 23515 or denial for insufficient operative detail.

See how Mira captures CPT 23480 documentation