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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: Upper Arm (Shoulder) Fracture Fixation

1015 hospitals in 77 markets. National Medicare rate $13,117, surgery center $9,194.

MarketHospitals25th pctMedian75th pctLow–high
Alabama (statewide)11$10,758$13,858$16,089$8,701–$23,708
Alaska (statewide)3———$9,604–$20,700
Arizona (statewide)9$9,132$10,746$15,236$7,469–$18,341
Arkansas (statewide)6$10,686$11,856$14,974$10,124–$16,155
Atlanta GA6$7,797$7,797$22,073$7,797–$27,126
Austin TX13$9,287$11,425$11,425$9,287–$19,281
Boston MA10$17,859$21,657$24,010$12,252–$26,918
California (statewide)54$18,107$25,780$46,008$8,492–$48,690
Charlotte NC5$15,297$15,297$15,297$15,089–$15,297
Chicago IL7$13,817$14,716$17,562$12,481–$22,164
Cleveland OH10$10,090$13,361$20,509$8,884–$25,507
Colorado (statewide)13$12,510$12,867$14,686$10,034–$23,415
Columbus OH2———$46,178–$46,178
Connecticut (statewide)1———$53,492–$53,492
Dallas-Fort Worth TX12$9,590$16,982$18,830$9,098–$38,304
Denver CO15$11,395$12,931$22,468$10,284–$23,415
Detroit MI8$9,374$10,318$12,808$7,877–$16,214
Florida (statewide)56$11,310$13,099$15,196$9,003–$27,122
Georgia (statewide)26$9,473$18,653$24,459$5,681–$31,990
Hawaii (statewide)3———$8,829–$13,708
Houston TX19$8,778$15,566$24,277$8,751–$25,932
Idaho (statewide)12$13,003$24,267$32,682$12,386–$39,877
Illinois (statewide)23$14,592$16,510$20,201$8,069–$38,226
Indiana (statewide)29$20,375$29,462$44,643$10,977–$50,276
Indianapolis IN3———$23,708–$57,617
Iowa (statewide)16$11,938$18,582$27,308$8,624–$35,136
Kansas (statewide)11$13,608$17,071$20,702$8,552–$35,250
Kentucky (statewide)11$12,523$17,338$22,674$6,561–$25,283
Las Vegas NV2———$7,907–$19,560
Los Angeles CA17$15,123$19,485$23,022$12,800–$35,667
Louisiana (statewide)24$10,542$11,734$14,490$7,102–$20,544
Maine (statewide)17$52,722$59,196$61,208$13,596–$76,956
Massachusetts (statewide)4———$12,252–$20,130
Miami-Fort Lauderdale FL1———$24,023–$24,023
Michigan (statewide)24$8,370$10,139$13,006$7,594–$24,498
Minneapolis-St. Paul MN8$8,918$13,082$20,617$8,560–$27,696
Minnesota (statewide)12$16,736$35,445$42,956$8,918–$58,164
Mississippi (statewide)14$13,705$17,690$17,823$6,892–$35,014
Missouri (statewide)14$10,705$14,828$16,868$6,897–$34,343
Montana (statewide)4———$8,204–$42,576
Nashville TN6$6,960$6,960$22,534$6,926–$27,964
Nebraska (statewide)11$10,220$10,220$13,512$7,907–$20,585
Nevada (statewide)4———$7,907–$19,678
New Hampshire (statewide)6$15,838$27,730$41,560$14,422–$57,492
New Jersey (statewide)21$12,088$14,808$14,930$8,458–$32,626
New Mexico (statewide)6$16,335$21,461$24,452$13,578–$35,292
New York (statewide)29$15,226$20,391$28,275$8,204–$44,471
New York City8$14,547$15,226$16,752$12,297–$21,908
North Carolina (statewide)5$11,952$13,195$19,175$7,186–$27,873
North Dakota (statewide)5$20,570$22,259$23,240$16,908–$30,070
Ohio (statewide)35$17,585$20,478$30,186$7,700–$49,348
Oklahoma (statewide)9$14,977$21,874$26,424$11,458–$42,384
Oregon (statewide)8$32,949$44,311$50,575$27,710–$61,050
Pennsylvania (statewide)31$19,680$28,166$43,711$9,176–$59,058
Philadelphia PA11$11,732$12,434$15,094$8,412–$23,987
Phoenix AZ6$10,746$10,746$10,746$10,746–$10,746
Pittsburgh PA7$17,929$26,129$27,549$9,487–$32,386
Portland OR9$20,708$20,708$24,555$17,589–$24,555
Rhode Island (statewide)3———$24,183–$26,796
Richmond VA3———$10,723–$10,996
Rio Grande Valley TX7$11,524$16,447$17,005$9,328–$22,930
Salt Lake City UT9$19,322$19,981$19,981$11,982–$20,640
San Antonio TX3———$8,638–$18,424
San Diego CA6$28,072$28,072$28,344$28,072–$30,449
San Francisco Bay Area CA4———$12,589–$38,045
Seattle-Tacoma WA16$35,503$36,274$46,498$29,799–$54,598
South Carolina (statewide)29$14,546$20,079$21,345$10,731–$28,795
South Dakota (statewide)2———$10,499–$20,401
Tampa FL6$16,642$16,642$16,642$15,523–$19,745
Tennessee (statewide)20$8,848$12,231$13,654$6,960–$27,758
Texas (statewide)76$11,451$15,844$18,830$6,561–$46,675
Utah (statewide)6$12,913$17,514$19,322$11,982–$19,981
Virginia (statewide)19$20,805$26,411$36,912$11,640–$43,511
Washington (statewide)12$28,974$37,798$42,978$13,329–$68,776
Washington DC9$9,266$12,181$12,181$8,403–$18,927
West Virginia (statewide)4———$12,304–$85,473
Wisconsin (statewide)29$12,996$12,996$20,860$7,984–$33,173

Lowest and highest 12 hospital medians

HospitalMarketMedian across insurers× MedicareInsurersFile date
Atrium Health Navicent PeachGeorgia (statewide)$5,6810.5×12025-11-19
Saint Joseph HospitalKentucky (statewide)$6,5610.5×12026-02-28
Chi St Joseph Health Regional HospitalTexas (statewide)$6,5610.5×12026-02-28
Jefferson County HospitalMississippi (statewide)$6,8920.6×42026-09-15
Boone Hospital CenterMissouri (statewide)$6,8970.5×12026-04-01
TriStar Skyline Medical CenterNashville TN$6,9260.6×22026-09-01
St Francis Hospital- Emory HealthcareGeorgia (statewide)$6,9600.6×22026-04-01
Tristar Horizon Medical CenterTennessee (statewide)$6,9600.6×22026-09-01
TriStar Summit Medical CenterNashville TN$6,9600.6×22026-09-01
TriStar Hendersonville Medical CenterNashville TN$6,9600.6×22026-09-01
TriStar StoneCrest Medical CenterNashville TN$6,9600.6×22026-09-01
Tristar Northcrest Medical CenterTennessee (statewide)$6,9960.6×22026-09-01
Mainehealth Pen Bay HospitalMaine (statewide)$60,4724.8×12025-09-09
Providence Medford Medical CenterOregon (statewide)$61,0504.0×22026-04-01
Northern Light Mercy HospitalMaine (statewide)$61,2084.7×22026-04-15
Northern Light Blue Hill Memorial HospitalMaine (statewide)$61,2084.8×22026-03-30
Northern Light C A Dean HospitalMaine (statewide)$61,2084.8×22026-03-30
Northern Light Sebasticook Valley HospitalMaine (statewide)$61,2084.8×22026-03-30
Providence Centralia HospitalWashington (statewide)$62,6044.4×42026-04-01
Mainehealth Waldo HospitalMaine (statewide)$63,2185.0×12025-09-09
Northern Light Mayo HospitalMaine (statewide)$64,4665.1×22026-03-30
Mary Bridge Children'S HospitalWashington (statewide)$68,7764.6×52026-08-27
Mainehealth Lincoln HospitalMaine (statewide)$76,9566.1×12025-09-09
Logan Regional Medical CenterWest Virginia (statewide)$85,4736.9×12026-04-01

Every hospital is on its state's page (linked in the market table) and in the interactive explorer.

Questions

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

Across 1015 hospitals in 77 markets (metro areas and statewide) that post a usable dollar rate, the median commercial rate for CPT 23615, hospital outpatient is $16,982, 1.3× the same hospital's local Medicare base rate. The middle half of hospitals runs $12,088 to $25,092. 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: Atrium Health Navicent Peach ($5,681), Saint Joseph Hospital ($6,561), Chi St Joseph Health Regional Hospital ($6,561). Highest: Logan Regional Medical Center ($85,473), Mainehealth Lincoln Hospital ($76,956), Mary Bridge Children'S Hospital ($68,776). Coverage: every hospital whose price file we could read.