2025 CPT code 23485
Effective Date: N/A Surgery - Musculoskeletal System Feed
Osteotomy of the clavicle, with or without internal fixation, including obtaining a bone graft for nonunion or malunion.
Modifiers such as 22 (increased procedural services), 54 (surgical care only), or 76 (repeat procedure by same physician) may be applicable depending on the specific circumstances.
Medical necessity for 23485 must be supported by documentation of failed conservative treatment, functional impairment, or pain due to nonunion or malunion of the clavicle fracture.
In simple words: This procedure corrects a poorly healed or unhealed collarbone fracture by surgically cutting the bone, adding a bone graft for stability, and possibly using internal hardware like plates and screws.
This procedure involves cutting the clavicle (collarbone) to correct a malunion or nonunion, often requiring a bone graft taken from another site. Internal fixation may be necessary. The procedure includes obtaining the graft and any necessary fixation.
Example 1: A patient presents with a nonunion of a clavicle fracture that has failed to heal after conservative treatment. CPT code 23485 is used for the osteotomy, bone grafting, and internal fixation., A patient has a malunited clavicle fracture causing functional impairment. The physician performs an osteotomy with bone grafting and internal fixation. CPT code 23485 is reported., A patient with a previous clavicle fracture experiences persistent pain due to nonunion. An osteotomy with bone grafting is performed. CPT 23485 is used, even if internal fixation is not required.
Documentation should include details of the fracture, evidence of nonunion or malunion, type of bone graft used, method of internal fixation (if any), and any associated procedures like obtaining the graft.
- Specialties:Orthopedic Surgery
- Place of Service: "Inpatient Hospital", "Ambulatory Surgical Center", "Outpatient Hospital"