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Upper arm (shoulder) fracture fixation: what insurers pay

Plate and screws for a broken top of the upper-arm bone. Commercial negotiated rates by hospital and market, next to Medicare for the same code.

Open the interactive explorerAll operations

CPT 23615: Optx Prox Humrl Fx W/Int Fix

83 hospitals in 32 markets. National Medicare rate $13,117, surgery center $9,194.

MarketHospitals25th pctMedian75th pctLow–high
Atlanta GA1———$7,797–$7,797
Austin TX2———$9,780–$11,425
Boston MA7$17,208$20,546$22,276$15,097–$25,680
California (statewide)1———$21,550–$21,550
Chicago IL5$12,918$14,832$20,291$12,481–$22,164
Cleveland OH5$9,457$23,019$26,296$9,257–$29,779
Columbus OH1———$46,178–$46,178
Dallas-Fort Worth TX4———$9,126–$41,120
Denver CO7$10,196$10,722$15,774$9,685–$19,278
Detroit MI3———$7,877–$9,407
Georgia (statewide)1———$9,172–$9,172
Houston TX1———$15,546–$15,546
Indianapolis IN1———$23,708–$23,708
Kansas (statewide)1———$10,705–$10,705
Las Vegas NV2———$7,907–$16,579
Los Angeles CA2———$18,158–$26,623
Minneapolis-St. Paul MN1———$17,246–$17,246
Nashville TN2———$6,960–$13,006
New York City3———$12,386–$23,928
Ohio (statewide)1———$18,767–$18,767
Pennsylvania (statewide)1———$23,679–$23,679
Philadelphia PA5$10,365$12,364$12,434$9,071–$13,320
Phoenix AZ3———$10,746–$10,746
Portland OR6$20,708$20,708$23,593$20,708–$24,555
Richmond VA2———$12,959–$12,992
San Antonio TX1———$8,724–$8,724
San Diego CA1———$16,513–$16,513
San Francisco Bay Area CA1———$38,045–$38,045
Seattle-Tacoma WA6$40,850$44,140$56,744$35,533–$60,220
Tampa FL2———$14,016–$16,642
Washington DC3———$10,915–$12,949
Wisconsin (statewide)1———$12,152–$12,152
HospitalMarketMedian across insurers× MedicareInsurersFile date
TriStar StoneCrest Medical CenterNashville TN$6,9600.6×22026-09-01
Emory University HospitalAtlanta GA$7,7970.6×52026-04-01
Trinity Health Oakland HospitalDetroit MI$7,8770.6×162026-03-31
Henderson HospitalLas Vegas NV$7,9070.6×12026-09-01
Methodist HospitalSan Antonio TX$8,7240.7×52026-09-01
Jefferson Stratford HospitalPhiladelphia PA$9,0710.6×32026-09-15
Baylor University Medical CenterDallas-Fort Worth TX$9,1260.7×32026-06-29
Emory Houston Hospital Warner RobinsGeorgia (statewide)$9,1720.8×32026-04-01
University Hospitals - Elyria Medical CenterCleveland OH$9,2570.8×12026-07-14
Henry Ford Health Rochester HospitalDetroit MI$9,2740.7×12026-01-01
Harper University HospitalDetroit MI$9,4070.7×12026-09-02
Cleveland Clinic (main campus)Cleveland OH$9,4570.8×12026-06-16
HCA HealthONE Presbyterian/St. Luke'sDenver CO$9,6850.7×32026-09-01
HCA HealthONE SwedishDenver CO$9,7500.7×32026-09-01
St David's Medical CenterAustin TX$9,7800.8×42026-09-01
Medical City MckinneyDallas-Fort Worth TX$9,9790.8×62026-09-01
Thomas Jefferson University HospitalPhiladelphia PA$10,3650.8×22026-09-15
Medical City PlanoDallas-Fort Worth TX$10,5510.8×62026-09-01
HCA HealthONE Sky RidgeDenver CO$10,6410.8×32026-09-01
Menorah Medical CenterKansas (statewide)$10,7050.9×42026-09-01
Hca Healthone RoseDenver CO$10,7220.8×32026-09-01
HonorHealth Scottsdale Osborn Medical CenterPhoenix AZ$10,7460.8×12026-04-01
HonorHealth Scottsdale Shea Medical CenterPhoenix AZ$10,7460.8×12026-04-01
HonorHealth Scottsdale Thompson Peak Medical CenterPhoenix AZ$10,7460.8×12026-04-01
Reston Hospital CenterWashington DC$10,9150.8×32026-09-01
Stonesprings Hospital CenterWashington DC$10,9150.8×32026-09-01
Ascension Seton Medical Center AustinAustin TX$11,4250.9×12026-01-01
Orthopaedic Hospital Of WisconsinWisconsin (statewide)$12,1520.9×32026-01-01
UCHealth University of Colorado HospitalDenver CO$12,2700.9×32025-11-01
Riddle Memorial HospitalPhiladelphia PA$12,3640.9×22026-04-01
Hospital for Special SurgeryNew York City$12,3860.8×62026-04-01
Bryn Mawr HospitalPhiladelphia PA$12,4340.9×22026-04-01
Endeavor Health Evanston HospitalChicago IL$12,4810.9×12026-04-01
Montefiore Medical CenterNew York City$12,9160.8×62026-04-01
Endeavor Health Northwest Community HospitalChicago IL$12,9180.9×22026-04-01
Inova Alexandria HospitalWashington DC$12,9491.0×32026-04-01
Henrico Doctors' HospitalRichmond VA$12,9591.0×32026-09-01
CJW Medical Center (Chippenham + Johnston-Willis)Richmond VA$12,9921.0×32026-09-01
Vanderbilt University Medical CenterNashville TN$13,0061.1×42025-10-01
Inspira Medical Center Mullica HillPhiladelphia PA$13,3200.9×12026-03-24
Tampa General HospitalTampa FL$14,0161.1×12026-04-01
Endeavor Health Elmhurst HospitalChicago IL$14,8321.1×22026-04-01
Winchester HospitalBoston MA$15,0971.0×22026-04-01
Houston Methodist HospitalHouston TX$15,5461.2×32026-04-01
Scripps Green HospitalSan Diego CA$16,5131.0×12026-03-30
University Medical Center of Southern NevadaLas Vegas NV$16,5791.2×72026-07-01
Morton Plant HospitalTampa FL$16,6421.2×22026-01-01
New England Baptist HospitalBoston MA$16,6871.1×32026-04-01
Park Nicollet Methodist HospitalMinneapolis-St. Paul MN$17,2461.3×22026-03-31
Beverly Hospital CorporationBoston MA$17,7291.1×12026-04-01
Keck Hospital Of UscLos Angeles CA$18,1581.1×42026-04-01
Bethesda NorthOhio (statewide)$18,7671.5×32026-04-01
Adventhealth PorterDenver CO$19,2781.4×22026-04-01
Adventhealth ParkerDenver CO$19,2781.4×22026-04-01
University of Chicago Medical CenterChicago IL$20,2911.5×22026-04-01
Beth Israel Deaconess Hospital - PlymouthBoston MA$20,5461.3×12026-04-01
Legacy Emanuel Medical CenterPortland OR$20,7081.4×52026-04-01
Legacy Good Samaritan Medical CenterPortland OR$20,7081.4×52026-04-01
Legacy Mount Hood Medical CenterPortland OR$20,7081.4×52026-04-01
Legacy Meridian Park Medical CenterPortland OR$20,7081.4×52026-04-01
Anna Jaques HospitalBoston MA$20,8941.4×22026-04-01
Los Robles Hospital & Medical CenterCalifornia (statewide)$21,5501.3×42026-09-01
Endeavor Health Edward HospitalChicago IL$22,1641.6×12026-04-01
Medina HospitalCleveland OH$23,0191.9×12026-06-15
Lahey Hospital & Medical Center, BurlingtonBoston MA$23,6581.5×12026-04-01
Lehigh Valley HospitalPennsylvania (statewide)$23,6791.8×82026-07-01
Riverview HealthIndianapolis IN$23,7081.8×22026-04-01
NYU Langone Hospitals (Orthopedic Hospital + Tisch files)New York City$23,9281.5×62026-01-01
Providence St Vincent Medical CenterPortland OR$24,5551.7×32026-04-01
Providence Portland Medical CenterPortland OR$24,5551.7×32026-04-01
Beth Israel Deaconess Medical CenterBoston MA$25,6801.7×22026-04-01
Cleveland Clinic Lutheran HospitalCleveland OH$26,2962.2×12026-06-15
Cedars-Sinai Medical CenterLos Angeles CA$26,6231.6×32025-11-26
Cleveland Clinic Hillcrest HospitalCleveland OH$29,7792.5×12026-06-15
Overlake Hospital Medical CenterSeattle-Tacoma WA$35,5332.4×52026-04-01
Stanford Health CareSan Francisco Bay Area CA$38,0452.0×42026-04-01
St Clare HospitalSeattle-Tacoma WA$40,6702.7×62026-02-28
Texas Health Presbyterian Hospital DallasDallas-Fort Worth TX$41,1203.2×22026-04-21
St Anthony HospitalSeattle-Tacoma WA$41,3882.8×62026-02-28
Mount Carmel New Albany Surgical HospitalColumbus OH$46,1783.7×182026-03-31
Swedish Medical CenterSeattle-Tacoma WA$46,8933.1×42026-04-01
Tacoma General Allenmore HospitalSeattle-Tacoma WA$60,0284.0×52026-08-27
Multicare Good Samaritan HospitalSeattle-Tacoma WA$60,2204.0×42026-08-27

Questions

How much do commercial insurers pay hospitals for upper arm (shoulder) fracture fixation?

Across 83 hospitals in 32 metro areas that post a usable dollar rate, the median commercial rate for CPT 23615, hospital outpatient is $14,832, 1.1× the same hospital's local Medicare base rate. The middle half of hospitals runs $10,734 to $21,857. Figures are each hospital's median across insurers, from its federal price-transparency file.

What does Medicare pay for upper arm (shoulder) fracture fixation?

Medicare's national hospital outpatient rate for CPT 23615 is $13,117 and its surgery-center rate is $9,194, before local wage adjustment.

Which hospitals post the lowest and highest commercial rates for upper arm (shoulder) fracture fixation?

Lowest medians: TriStar StoneCrest Medical Center ($6,960), Emory University Hospital ($7,797), Trinity Health Oakland Hospital ($7,877). Highest: Multicare Good Samaritan Hospital ($60,220), Tacoma General Allenmore Hospital ($60,028), Swedish Medical Center ($46,893). Coverage is limited to the markets listed on this page.