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CPT code 23545: AC joint treatment, closed, with manipulation2026 Medicare rate & RVUs in Connecticut

Reports physician-performed closed reduction of an acromioclavicular joint dislocation when manipulation is used, rather than treatment without manipulation or open reconstruction.

CMS RVU26DEffective Oct 1, 2026One payment locality80 Medicare services in 2024

In Connecticut, Medicare pays $538.00 for 23545 in the office and $456.34 when it’s performed in a hospital or facility.

$538.00Office (non-facility)
$456.34Hospital or facility
+7.2%vs the national office rate ($502.02)

Check a contract rate as a % of Medicare · 23545 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 23545 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 23545 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 23545 covers

This service treats a dislocation of the acromioclavicular joint, where the clavicle meets the acromion, by manipulating the joint to restore alignment without open repair. An orthopedic surgeon commonly performs it in an acute-care or surgical setting. The patient may then be immobilized, for example in a sling, as part of the treatment plan.

Choose this code when the physician performs manipulation as part of closed treatment; treatment without manipulation is represented by a different code. Document the dislocation, the side, the manipulation and reduction performed, and the resulting treatment plan. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Connecticut compares for 23545

Across 109 of 109 payment localities, the office rate for 23545 runs from $437.42 in Arkansas to $661.75 in San Benito County, CA. Connecticut pays $538.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

23545 in Connecticut vs other payment areas
  1. Connecticut · this page$538.00
  2. Los Angeles, CA · California$563.65+$25.65
  3. Washington, DC area · District of Columbia$575.74+$37.74
  4. Miami, FL · Florida$559.28+$21.28
  5. Chicago, IL · Illinois$540.51+$2.51
  6. Manhattan, NY · New York$584.16+$46.16
  7. Alaska · Alaska$568.93+$30.93

Other areas in Connecticut first, then benchmark localities. Bars start at $0.

Every other payment area

23545 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$444.64$378.30
ArkansasArkansas$437.42$372.30
ArizonaArizona$486.78$413.31
Bakersfield, CACalifornia$528.12$445.02
Chico, CACalifornia$525.87$442.77
El Centro, CACalifornia$526.01$442.91
Fresno, CACalifornia$525.87$442.77
Hanford, CACalifornia$525.87$442.77

23545 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$437.42

$593.81

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
23545 office rate range by state
State / territoryOffice rate rangeLocalities
AK$568.931
AL$444.641
AR$437.421
AZ$486.781
CA$525.87–$661.7529
CO$520.501
CT$538.001
DC$575.741
DE$495.421
FL$500.00–$559.283
GA$468.16–$513.732
GU$540.041
HI$540.041
IA$454.471
ID$458.391
IL$486.07–$540.514
IN$461.291
KS$453.441
KY$459.401
LA$459.14–$484.382
MA$517.40–$573.912
MD$505.21–$575.743
ME$462.52–$488.522
MI$474.03–$508.342
MN$493.021
MO$451.24–$484.663
MS$444.361
MT$501.961
NC$467.701
ND$485.551
NE$456.841
NH$513.421
NJ$542.54–$568.972
NM$477.481
NV$497.751
NY$475.65–$601.475
OH$470.681
OK$457.021
OR$492.33–$536.972
PA$470.75–$524.252
PR$505.591
RI$513.111
SC$470.291
SD$483.611
TN$456.171
TX$467.40–$520.128
UT$477.421
VA$487.70–$575.742
VI$505.591
VT$484.691
WA$516.06–$584.862
WI$467.601
WV$466.451
WY$494.811

See 23545 in every payment locality

How the 23545 rate is calculated

Each of 23545’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 23545

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.34

3.34 RVUs× 1.000 GPCI

Practice expense10.86

10.86 RVUs× 1.000 GPCI

Malpractice0.83

0.83 RVUs× 1.000 GPCI

Adjusted RVUs

15.0300

Conversion factor

$33.4009

Medicare rate

$502.02

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,226

Code
23545
Physician work
3.34
Practice expense
10.86
Malpractice
0.83

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 23545 in Connecticut
ComponentRVULocality factorAdjusted
Physician work3.34× 1.0203.4068
Practice expense10.86× 1.07711.6962
Malpractice0.83× 1.2101.0043
Total RVUs16.1073
Conversion factor× 33.4009

Office rate, Connecticut$538.00

Office: (3.34 × 1.02 + 10.86 × 1.077 + 0.83 × 1.21) × $33.4009 = $538.00

Facility: (3.34 × 1.02 + 8.59 × 1.077 + 0.83 × 1.21) × $33.4009 = $456.34

Open 23545 in the RVU calculator

Payment rules and modifiers for 23545

23545 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23545

AC joint treatment, closed, with manipulation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 23545

AC joint treatment, closed, with manipulation

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

23545 without 50 · national office

$502.02

AC joint treatment, closed, with manipulation

23545-50 · Bilateral: 150%

$753.03

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 23545

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 23545
CodeHow it relatesOffice range, Connecticut
Same family
23540AC joint dislocation, without manipulationClosed treatment of an AC dislocation without manipulation.$295.65
Used instead
23550AC joint repair, open treatment without graftOpen treatment of an AC dislocation without the graft distinction.No office rate
23552AC joint reconstruction, with graftOpen treatment of an AC dislocation with a graft.No office rate

How 23545 has changed in Connecticut

23545 · Office / nonfacility

$538.00

Effective 2026-10-01

The base rate is $139.59 higher than on 2025-10-01, moving from $398.41 to $538.00 (35.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $398.41changed to$538.00

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.43 changed to 3.34
    • Practice expense RVU 7.28 changed to 10.86
    • Malpractice RVU 0.72 changed to 0.83
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $405.36changed to$398.41

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.13 changed to 7.28
    • Malpractice RVU 0.74 changed to 0.72

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $398.74changed to$405.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $404.62changed to$398.74

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.93 changed to 7.13
    • Malpractice RVU 0.72 changed to 0.74
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $394.19changed to$404.62

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.42 changed to 6.93
    • Malpractice RVU 0.73 changed to 0.72
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $386.70changed to$394.19

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.16 changed to 6.42
    • Malpractice RVU 0.71 changed to 0.73

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $385.19changed to$386.70

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.75 changed to 6.16
    • Malpractice RVU 0.68 changed to 0.71
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $388.68changed to$385.19

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.94 changed to 5.75
    • Malpractice RVU 0.54 changed to 0.68
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $387.78changed to$388.68

    • Malpractice RVU 0.52 changed to 0.54

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $383.90changed to$387.78

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.82 changed to 5.94
    • Malpractice RVU 0.55 changed to 0.52

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $374.53changed to$383.90

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.60 changed to 5.82
    • Malpractice RVU 0.54 changed to 0.55
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $378.35changed to$374.53

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.70 changed to 5.60
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $381.09changed to$378.35

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.69 changed to 5.70
    • Malpractice RVU 0.58 changed to 0.54

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $379.19changed to$381.09

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $376.10changed to$379.19

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.63 changed to 5.69
    • Malpractice RVU 0.57 changed to 0.58
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $388.30changed to$376.10

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.45 changed to 5.63
    • Malpractice RVU 0.60 changed to 0.57
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $388.30

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$538.00$456.34RVU26D
2026-07-01$538.00$456.34RVU26C
2026-04-01$538.00$456.34RVU26B
2026-01-01$538.00$456.34RVU26A
2025-10-01$398.41$356.42RVU25D
2025-07-01$398.41$356.42RVU25C
2025-04-01$398.41$356.42RVU25B
2025-01-01$398.41$356.42RVU25A
2024-10-01$405.36$362.87RVU24D
2024-07-01$405.36$362.87RVU24C
2024-04-01$405.36$362.87RVU24B
2024-03-09$405.36$362.87RVU24AR
2024-01-01$398.74$356.94RVU24A
2023-10-01$404.62$361.67RVU23D
2023-07-01$404.62$361.67RVU23C
2023-04-01$404.62$361.67RVU23B
2023-01-01$404.62$361.67RVU23A
2022-10-01$394.19$352.55RVU22D
2022-07-01$394.19$352.55RVU22C
2022-04-01$394.19$352.55RVU22B
2022-01-01$394.19$352.55RVU22A
2021-10-01$386.70$346.66RVU21D
2021-07-01$386.70$346.66RVU21C
2021-04-01$386.70$346.66RVU21B
2021-01-01$386.70$346.66RVU21A
2020-10-01$385.19$347.43RVU20D
2020-07-01$385.19$347.43RVU20C
2020-04-01$385.19$347.43RVU20B
2020-01-01$385.19$347.43RVU20A
2019-10-01$388.68$349.41RVU19D
2019-07-01$388.68$349.41RVU19C
2019-04-01$387.78$348.50RVU19B
2019-01-01$387.78$348.50RVU19A
2018-10-01$383.90$346.67RVU18D
2018-07-01$383.90$346.67RVU18C
2018-04-01$383.90$346.67RVU18B
2018-01-01$383.90$346.67RVU18AR1
2017-10-01$374.53$340.45RVU17D
2017-07-01$374.53$340.45RVU17C
2017-04-01$374.53$340.45RVU17B
2017-01-01$374.53$340.45RVU17A
2016-10-01$378.35$343.44RVU16D
2016-07-01$378.35$343.44RVU16C
2016-04-01$378.35$343.44RVU16B
2016-01-01$378.35$343.44RVU16A
2015-10-01$381.09$345.24RVU15D
2015-07-01$381.09$345.24RVU15C
2015-04-01$379.19$343.52RVU15B
2015-01-01$379.19$343.52RVU15A
2014-10-01$376.10$341.71RVU14D
2014-07-01$376.10$341.71RVU14C
2014-04-01$376.10$341.71RVU14B
2014-01-01$376.10$341.71RVU14A
2013-10-01$388.30$350.53RVU13D
2013-07-01$388.30$350.53RVU13C
2013-04-01$388.30$350.53RVU13B
2013-01-01$388.30$350.53RVU13AR

Price 23545 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

23545 billing questions

How does this differ from 23540?

Use 23545 when manipulation is performed as part of closed treatment of the AC dislocation. Code 23540 represents closed treatment without manipulation.

When would an open-treatment code be more appropriate?

Use an open-treatment code when the surgeon treats the AC dislocation through an open approach, rather than by closed manipulation. Code 23550 covers open treatment without the graft distinction found in 23552.

What documentation supports reporting this code?

Document the AC dislocation, laterality, the manipulation performed to reduce it, and the post-treatment plan. The record should make clear that manipulation was part of the closed treatment.

How is bilateral treatment handled?

For bilateral procedures, CMS specifies modifier 50 and payment at 150%. Document the treatment performed on each side.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Related routine follow-up during that period is included in the global service.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. CMS does not permit co-surgeons or team surgery for this code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 23545PPRRVU2026_Oct_nonQPP.csv, line 2,226 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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