How Much Does Cltx Prox Humrl Fracture without Manipulation under Cost?
Also known as: Cltx prox humrl fx w/o mnpj (CPT 23600)
Non-surgical treatment of a proximal humerus (upper arm near shoulder) fracture.
The total estimated cost of Cltx Prox Humrl Fracture without Manipulation under (CPT 23600) is $1,115 to $2,091, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $332.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Cltx Prox Humrl Fracture without Manipulation under
What you need to know before your appointment
What to Expect
The doctor immobilizes your arm in a sling. Most non-displaced proximal humerus fractures heal without surgery.
How Long Does It Take?
Office visit plus 6-12 weeks healing
Common Reasons Doctors Order This
Shoulder fracture from fall, proximal humerus fracture in elderly patients
How to Prepare
Wear the sling faithfully. Start pendulum exercises as directed. Avoid lifting.
Procedures Commonly Done Together
These procedures are frequently performed alongside Cltx prox humrl fx w/o mnpj
How to Reduce Your Cost for Cltx prox humrl fx w/o mnpj
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
For this procedure, the office rate ($381) differs from the facility rate ($332). Ask if it can be done in an office setting.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (11.41) x CF ($33.40) = $381
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Cltx prox humrl fx w/o mnpj cost?
The Medicare facility rate for Cltx prox humrl fx w/o mnpj is $332. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Cltx prox humrl fx w/o mnpj cost without insurance?
Without insurance, the cost of Cltx prox humrl fx w/o mnpj can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Cltx prox humrl fx w/o mnpj?
Most commercial health insurance plans and Medicare cover Cltx prox humrl fx w/o mnpj when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.