CPT 23515 Surgery - Musculoskeletal

How Much Does Optx Clavicular Fracture with Internal Fix Cost?

Also known as: Optx clavicular fx w/int fix (CPT 23515)

Surgical treatment of a clavicle fracture with internal fixation.

The total estimated cost of Optx Clavicular Fracture with Internal Fix (CPT 23515) is $2,282 to $4,278, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $679.

Total Estimated Cost of Care

$2,282 — $4,278

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

Surgeon/Physician Fee
$679
Hospital Facility Fee
$2,037
Anesthesia (est.)
$136
Important: The physician fee of $679 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)
$679
Physician component only — CMS PFS 2026

Patient Guide: Optx Clavicular Fracture with Internal Fix

What you need to know before your appointment

What to Expect

Under anesthesia, the surgeon realigns the broken collarbone and secures it with a plate and screws.

How Long Does It Take?

1-2 hours

Common Reasons Doctors Order This

Displaced clavicle fracture, shortened clavicle fracture, clavicle fracture at risk of nonunion

How to Prepare

Fast before surgery. Sling for 4-6 weeks. Avoid overhead lifting for 3 months.

Procedures Commonly Done Together

These procedures are frequently performed alongside Optx clavicular fx w/int fix

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How to Reduce Your Cost for Optx clavicular fx w/int fix

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

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 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.

9.45
Work RVU
8.94
Practice Expense RVU
1.94
Malpractice RVU
20.33
Total RVU

Payment = Total RVU (20.33) x CF ($33.40) = $679

Frequently Asked Questions

How much does Optx clavicular fx w/int fix cost?

The Medicare facility rate for Optx clavicular fx w/int fix is $679. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Optx clavicular fx w/int fix cost without insurance?

Without insurance, the cost of Optx clavicular fx w/int fix 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 Optx clavicular fx w/int fix?

Most commercial health insurance plans and Medicare cover Optx clavicular fx w/int fix 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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