$437.42–$661.75
Both address closed treatment of an AC dislocation; choose 23540 when treatment involves no manipulation and 23545 when the joint is manipulated.
On this page
CMS RVU26D · Effective 2026-10-01
23540 AC joint dislocation Medicare reimbursement rates
Reports nonoperative treatment of an acromioclavicular joint dislocation when the physician treats the injury without manipulating the joint. Compare 23540 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 23540?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$242.77–$358.47
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $115.70 per service.
Facility setting
$225.84–$330.05
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $104.21 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 23540 pays more and less
109 payment localities
$242.77 to $358.47
Orthopedic surgery
About 23540: Closed treatment of AC joint dislocation
Reports nonoperative treatment of an acromioclavicular joint dislocation when the physician treats the injury without manipulating the joint.
This service covers definitive nonoperative care for an acromioclavicular (AC) joint dislocation, the separation between the distal clavicle and the acromion. An orthopedic surgeon or other qualified physician may manage a traumatic AC separation with measures such as immobilization and a treatment plan that avoids joint manipulation. The code is specific to the AC joint, not a sternoclavicular dislocation or a clavicle fracture.
Report it when the physician assumes treatment of the dislocation without manipulating it; documentation should identify the injury and side, the treatment decision, and the nonoperative plan. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral treatment reported with modifier 50, CMS pays at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 23540
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.30 · 28%
- Practice expense (office) RVU5.49 · 66%
- Malpractice RVU0.49 · 6%
246
Medicare services in 2024 · #4149 by national volume
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.
23540 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
This code describes nonoperative treatment without manipulation. Use 23550 when the AC dislocation is treated by an open procedure.
$237.50–$351.18
This code concerns a sternoclavicular dislocation, at the joint between the sternum and clavicle. Code 23540 is for the acromioclavicular joint.
$226.74–$334.85
This code is for a clavicle fracture, not an AC joint dislocation. Select according to the documented injury.
See how rates vary across the country
23540 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$242.77
$323.18
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $319.54 | 1 |
| AL | $246.54 | 1 |
| AR | $242.77 | 1 |
| AZ | $268.52 | 1 |
| CA | $287.88–$358.47 | 29 |
| CO | $285.63 | 1 |
| CT | $295.65 | 1 |
| DC | $315.20 | 1 |
| DE | $273.09 | 1 |
| FL | $276.72–$309.10 | 3 |
| GA | $259.90–$283.01 | 2 |
| GU | $294.79 | 1 |
| HI | $294.79 | 1 |
| IA | $251.10 | 1 |
| ID | $253.26 | 1 |
| IL | $269.82–$299.21 | 4 |
| IN | $254.76 | 1 |
| KS | $250.84 | 1 |
| KY | $254.81 | 1 |
| LA | $254.78–$267.97 | 2 |
| MA | $284.18–$313.48 | 2 |
| MD | $278.19–$315.20 | 3 |
| ME | $255.70–$268.87 | 2 |
| MI | $262.72–$281.37 | 2 |
| MN | $270.36 | 1 |
| MO | $250.83–$267.79 | 3 |
| MS | $246.80 | 1 |
| MT | $276.53 | 1 |
| NC | $258.37 | 1 |
| ND | $266.84 | 1 |
| NE | $252.26 | 1 |
| NH | $282.03 | 1 |
| NJ | $298.09–$311.85 | 2 |
| NM | $264.63 | 1 |
| NV | $274.01 | 1 |
| NY | $262.53–$330.16 | 5 |
| OH | $260.74 | 1 |
| OK | $253.29 | 1 |
| OR | $270.97–$293.95 | 2 |
| PA | $260.62–$288.62 | 2 |
| PR | $278.33 | 1 |
| RI | $282.30 | 1 |
| SC | $260.17 | 1 |
| SD | $265.69 | 1 |
| TN | $252.30 | 1 |
| TX | $258.89–$285.48 | 8 |
| UT | $263.89 | 1 |
| VA | $268.63–$315.20 | 2 |
| VI | $278.33 | 1 |
| VT | $266.64 | 1 |
| WA | $283.37–$319.03 | 2 |
| WI | $257.53 | 1 |
| WV | $259.59 | 1 |
| WY | $272.30 | 1 |
Compare 23540 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $246.54 | Facility $229.29 |
| Alaska* | Office $319.54 | Facility $298.55 |
| Arizona | Office $268.52 | Facility $249.42 |
| Arkansas | Office $242.77 | Facility $225.84 |
| Atlanta | Office $283.01 | Facility $262.99 |
| Austin | Office $285.48 | Facility $264.63 |
| Bakersfield | Office $289.22 | Facility $267.63 |
| Baltimore/Surr. Cntys | Office $295.05 | Facility $273.91 |
| Beaumont | Office $258.89 | Facility $240.96 |
| Brazoria | Office $271.92 | Facility $252.39 |
| Chicago | Office $299.21 | Facility $279.40 |
| Chico | Office $287.88 | Facility $266.28 |
| Colorado | Office $285.63 | Facility $264.67 |
| Connecticut | Office $295.65 | Facility $274.43 |
| Dallas | Office $274.19 | Facility $254.57 |
| Dc + Md/Va Suburbs | Office $315.20 | Facility $291.98 |
| Delaware | Office $273.09 | Facility $253.62 |
| Detroit | Office $281.37 | Facility $262.35 |
| East St. Louis | Office $278.49 | Facility $260.36 |
| El Centro | Office $287.96 | Facility $266.36 |
| Fort Lauderdale | Office $292.17 | Facility $272.20 |
| Fort Worth | Office $272.57 | Facility $253.14 |
| Fresno | Office $287.88 | Facility $266.28 |
| Galveston | Office $273.08 | Facility $253.51 |
| Hanford-Corcoran | Office $287.88 | Facility $266.28 |
| Hawaii, Guam | Office $294.79 | Facility $272.38 |
| Houston | Office $282.04 | Facility $262.48 |
| Idaho | Office $253.26 | Facility $235.13 |
| Indiana | Office $254.76 | Facility $236.49 |
| Iowa | Office $251.10 | Facility $233.07 |
| Kansas | Office $250.84 | Facility $233.02 |
| Kentucky | Office $254.81 | Facility $237.30 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $307.77 | Facility $284.45 |
| Madera | Office $287.88 | Facility $266.28 |
| Manhattan | Office $320.77 | Facility $297.87 |
| Merced | Office $287.88 | Facility $266.28 |
| Metropolitan Boston | Office $313.48 | Facility $289.95 |
| Metropolitan Kansas City | Office $265.00 | Facility $246.49 |
| Metropolitan Philadelphia | Office $288.62 | Facility $268.10 |
| Metropolitan St. Louis | Office $267.79 | Facility $249.03 |
| Miami | Office $309.10 | Facility $288.59 |
| Minnesota | Office $270.36 | Facility $250.08 |
| Mississippi | Office $246.80 | Facility $229.83 |
| Modesto | Office $287.88 | Facility $266.28 |
| Montana** | Office $276.53 | Facility $256.82 |
| Napa | Office $331.66 | Facility $305.69 |
| Nebraska | Office $252.26 | Facility $234.07 |
| Nevada** | Office $274.01 | Facility $254.28 |
| New Hampshire | Office $282.03 | Facility $261.52 |
| New Mexico | Office $264.63 | Facility $246.56 |
| New Orleans | Office $267.97 | Facility $249.42 |
| North Carolina | Office $258.37 | Facility $239.98 |
| North Dakota** | Office $266.84 | Facility $247.13 |
| Northern Nj | Office $311.85 | Facility $288.99 |
| Nyc Suburbs/Long Island | Office $330.16 | Facility $306.73 |
| Ohio | Office $260.74 | Facility $242.75 |
| Oklahoma | Office $253.29 | Facility $235.69 |
| Oxnard-Thousand Oaks-Ventura | Office $305.91 | Facility $282.62 |
| Portland | Office $293.95 | Facility $272.06 |
| Poughkpsie/N Nyc Suburbs | Office $300.87 | Facility $279.29 |
| Puerto Rico | Office $278.33 | Facility $258.41 |
| Queens | Office $322.08 | Facility $298.79 |
| Redding | Office $287.88 | Facility $266.28 |
| Rest Of California | Office $287.88 | Facility $266.28 |
| Rest Of Florida | Office $276.72 | Facility $257.88 |
| Rest Of Georgia | Office $259.90 | Facility $242.32 |
| Rest Of Illinois | Office $269.82 | Facility $251.83 |
| Rest Of Louisiana | Office $254.78 | Facility $237.34 |
| Rest Of Maine | Office $255.70 | Facility $237.57 |
| Rest Of Maryland | Office $278.19 | Facility $258.24 |
| Rest Of Massachusetts | Office $284.18 | Facility $263.43 |
| Rest Of Michigan | Office $262.72 | Facility $244.73 |
| Rest Of Missouri | Office $250.83 | Facility $233.84 |
| Rest Of New Jersey | Office $298.09 | Facility $276.57 |
| Rest Of New York | Office $262.53 | Facility $243.81 |
| Rest Of Oregon | Office $270.97 | Facility $251.34 |
| Rest Of Pennsylvania | Office $260.62 | Facility $242.53 |
| Rest Of Texas | Office $265.62 | Facility $246.92 |
| Rest Of Washington | Office $283.37 | Facility $262.61 |
| Rhode Island | Office $282.30 | Facility $261.95 |
| Riverside-San Bernardino-Ontario | Office $293.14 | Facility $271.54 |
| Sacramento-Roseville-Folsom | Office $301.62 | Facility $278.70 |
| Salinas | Office $300.50 | Facility $277.66 |
| San Diego-Chula Vista-Carlsbad | Office $307.31 | Facility $283.74 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $350.19 | Facility $322.40 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $349.63 | Facility $321.84 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $358.47 | Facility $330.05 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $356.19 | Facility $327.77 |
| San Luis Obispo-Paso Robles | Office $295.76 | Facility $273.31 |
| Santa Cruz-Watsonville | Office $310.00 | Facility $286.06 |
| Santa Maria-Santa Barbara | Office $301.56 | Facility $278.58 |
| Santa Rosa-Petaluma | Office $313.08 | Facility $288.88 |
| Seattle (King Cnty) | Office $319.03 | Facility $294.85 |
| South Carolina | Office $260.17 | Facility $241.96 |
| South Dakota** | Office $265.69 | Facility $245.99 |
| Southern Maine | Office $268.87 | Facility $249.34 |
| Stockton | Office $287.88 | Facility $266.28 |
| Suburban Chicago | Office $294.68 | Facility $274.44 |
| Tennessee | Office $252.30 | Facility $234.38 |
| Utah | Office $263.89 | Facility $245.36 |
| Vallejo | Office $330.86 | Facility $304.88 |
| Vermont | Office $266.64 | Facility $247.13 |
| Virgin Islands | Office $278.33 | Facility $258.41 |
| Virginia | Office $268.63 | Facility $249.26 |
| Visalia | Office $287.88 | Facility $266.28 |
| West Virginia | Office $259.59 | Facility $242.47 |
| Wisconsin | Office $257.53 | Facility $238.65 |
| Wyoming** | Office $272.30 | Facility $252.60 |
| Yuba City | Office $287.88 | Facility $266.28 |
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23540 billing questions
How is this code different from 23545?
Use 23540 when the AC dislocation is treated without manipulating the joint. Code 23545 is the corresponding closed-treatment option when manipulation is performed.
Does the global period include follow-up care?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported?
For treatment of both AC joints, report modifier 50. CMS pays bilateral reporting at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
What documentation supports reporting this service?
Document the AC joint dislocation, the affected side, the decision to manage it nonoperatively, and that the joint was not manipulated.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,22223525,,Cltx strnclav dislc w/mnpj,A,,3.70,8.87,,6.50,,0.79,13.36,10.99,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22323530,,Optx strnclav dislc aqt/chrn,A,,7.29,7.61,NA,7.61,,1.54,16.44,16.44,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22423532,,Optx strclv dslc aq/chrn grf,A,,8.00,8.18,NA,8.18,,1.70,17.88,17.88,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22523540,,Cltx acromclav dislc wo mnpj,A,,2.30,5.49,,4.90,,0.49,8.28,7.69,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22623545,,Cltx acromclav dislc w/mnpj,A,,3.34,10.86,,8.59,,0.83,15.03,12.76,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22723550,,Optx acromclv dislc aqt/chrn,A,,7.40,7.33,NA,7.33,,1.46,16.19,16.19,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22823552,,Optx acrclv dslc aq/chrn grf,A,,8.60,8.04,NA,8.04,,1.69,18.33,18.33,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00