How much does Medicare pay for CPT 23600?

Medicare allowed an average of $335.02 per service and paid $260.97 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1329.81, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 23600?

Closed treatment of broken top of upper arm bone. It was billed 2,309 times to 2,304 Medicare beneficiaries by 152 providers in 2024.

Does 23600 pay differently in an office than a hospital?

Yes. The allowed amount averaged $339.33 in an office setting and $309.63 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 23600 most?

Orthopedic Surgery, with 1,747 services from 114 clinicians. Next are Physician Assistant, Hand Surgery, Sports Medicine.

CPT 23600

Closed treatment of broken top of upper arm bone

$335.02Medicare-allowed amount per service, averaged across 2,309 services

Providers submitted

$1329.81

Asking price, not received

Medicare allowed

$335.02

The fee schedule figure

Medicare paid

$260.97

Balance is patient coinsurance

Providers submitted an average of $1329.81 for this code and Medicare allowed $335.02 — 4.0× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $260.97 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $339.33
Hospital / facility: $309.63

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,974 services were billed in an office setting and 335 in a facility.

Services: 2,309
Beneficiaries: 2,304
Providers billing it: 152
Total allowed: $773,561

What Medicare pays for CPT 23600

Across 2,309 services billed by 152 providers to 2,304 beneficiaries, Medicare allowed an average of $335.02 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 23600

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	1,747	1,742	$343.13	114
Physician Assistant	313	313	$278.03	22
Hand Surgery	131	131	$386.48	8
Sports Medicine	72	72	$338.61	5
Nurse Practitioner	46	46	$262.49	3

23600 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	353	$344.23	$260.55	20
New York	301	$390.27	$266.04	20
Pennsylvania	166	$321.07	$246.84	10
Massachusetts	155	$341.74	$244.41	11
New Jersey	135	$360.96	$267.04	9
Illinois	128	$312.25	$247.31	9
Virginia	113	$311.84	$241.68	9
California	107	$365.39	$256.47	6
Ohio	91	$268.95	$228.97	6
South Carolina	78	$307.67	$256.60	5
Arizona	72	$314.95	$245.71	4
Louisiana	62	$371.39	$263.77	3
Iowa	55	$308.75	$232.25	4
Mississippi	51	$306.62	$248.00	4
North Carolina	50	$315.79	$241.50	4
Oklahoma	47	$291.40	$238.99	3
Delaware	39	$330.55	$267.55	2
Maryland	34	$365.26	$254.03	3
Kentucky	34	$317.33	$254.57	2
Michigan	30	$342.99	$248.31	2
Missouri	30	$320.03	$259.27	2
New Mexico	27	$275.36	$206.16	2
Nebraska	15	$285.73	$223.77	1
Rhode Island	14	$349.77	$272.08	1
Nevada	14	$290.81	$239.25	1
Minnesota	13	$333.60	$268.87	1
West Virginia	13	$269.51	$224.81	1
Connecticut	13	$367.97	$272.03	1
Tennessee	13	$263.68	$194.68	1
Alabama	12	$276.96	$238.56	1
Georgia	11	$269.65	$220.93	1
Texas	11	$312.42	$257.09	1
Oregon	11	$282.53	$228.52	1
Indiana	11	$311.90	$271.50	1

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.