CPT 23575 Surgery - Musculoskeletal

How Much Does Cltx Scap Fracture with Manipulation under +-tractj Cost?

Also known as: Cltx scap fx w/mnpj +-tractj (CPT 23575)

The total estimated cost of Cltx Scap Fracture with Manipulation under +-tractj (CPT 23575) is $1,274 to $2,389, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $379.

Total Estimated Cost of Care

$1,274 — $2,389

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$379
Hospital Facility Fee
$1,137
Anesthesia (est.)
$76
Important: The physician fee of $379 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$379
Physician component only — CMS PFS 2026
Medicare Physician Fee (Office/Clinic)
$459
Non-facility setting

Procedures Commonly Done Together

These procedures are frequently performed alongside Cltx scap fx w/mnpj +-tractj

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How to Reduce Your Cost for Cltx scap fx w/mnpj +-tractj

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 ($459) differs from the facility rate ($379). 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.

4.12
Work RVU
6.35
Practice Expense RVU
0.88
Malpractice RVU
13.74
Total RVU

Payment = Total RVU (13.74) x CF ($33.40) = $459

Frequently Asked Questions

How much does Cltx scap fx w/mnpj +-tractj cost?

The Medicare facility rate for Cltx scap fx w/mnpj +-tractj is $379. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Cltx scap fx w/mnpj +-tractj cost without insurance?

Without insurance, the cost of Cltx scap fx w/mnpj +-tractj 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 scap fx w/mnpj +-tractj?

Most commercial health insurance plans and Medicare cover Cltx scap fx w/mnpj +-tractj 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.

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