Billing code 23545: AC joint treatmentMedicare rate & RVUs
Reports physician-performed closed reduction of an acromioclavicular joint dislocation when manipulation is used, rather than treatment without manipulation or open reconstruction.
Medicare pays $502.02 for 23545 nationally in the office and $426.20 in a hospital or facility. Local office rates run $437.42–$661.75.
Medicare rate · 23545
AC joint treatment
Swap in your local Medicare rate.
- Work RVUs
- 3.34
- Total RVUs
- 15.03
- Global days
- 090
National rate · 2026
$502.02
Office setting, before claim adjustments.
See every locality for 23545 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
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.
Where 23545 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$437.42 to $661.75
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $444.64 | $378.30 |
| Alaska* | $568.93 | $488.18 |
| Arizona | $486.78 | $413.31 |
| Arkansas | $437.42 | $372.30 |
| Atlanta | $513.73 | $436.69 |
| Austin | $520.12 | $439.90 |
| Bakersfield | $528.12 | $445.02 |
| Baltimore/Surr. Cntys | $536.85 | $455.50 |
| Beaumont | $467.40 | $398.40 |
| Brazoria | $493.54 | $418.41 |
| Chicago | $540.51 | $464.31 |
| Chico | $525.87 | $442.77 |
| Colorado | $520.50 | $439.83 |
| Connecticut | $538.00 | $456.34 |
| Dallas | $497.63 | $422.12 |
| Dc + Md/Va Suburbs | $575.74 | $486.42 |
| Delaware | $495.42 | $420.51 |
| Detroit | $508.34 | $435.17 |
| East St. Louis | $501.11 | $431.35 |
| El Centro | $526.01 | $442.91 |
| Fort Lauderdale | $529.13 | $452.33 |
| Fort Worth | $494.37 | $419.61 |
| Fresno | $525.87 | $442.77 |
| Galveston | $495.60 | $420.31 |
| Hanford-Corcoran | $525.87 | $442.77 |
| Hawaii, Guam | $540.04 | $453.83 |
| Houston | $510.79 | $435.50 |
| Idaho | $458.39 | $388.63 |
| Indiana | $461.29 | $391.00 |
| Iowa | $454.47 | $385.09 |
| Kansas | $453.44 | $384.90 |
| Kentucky | $459.40 | $391.99 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $563.65 | $473.96 |
| Madera | $525.87 | $442.77 |
| Manhattan | $584.16 | $496.06 |
| Merced | $525.87 | $442.77 |
| Metropolitan Boston | $573.91 | $483.38 |
| Metropolitan Kansas City | $479.25 | $408.06 |
| Metropolitan Philadelphia | $524.25 | $445.32 |
| Metropolitan St. Louis | $484.66 | $412.48 |
| Miami | $559.28 | $480.35 |
| Minnesota | $493.02 | $415.00 |
| Mississippi | $444.36 | $379.08 |
| Modesto | $525.87 | $442.77 |
| Montana** | $501.96 | $426.14 |
| Napa | $610.75 | $510.82 |
| Nebraska | $456.84 | $386.86 |
| Nevada** | $497.75 | $421.85 |
| New Hampshire | $513.42 | $434.49 |
| New Mexico | $477.48 | $407.95 |
| New Orleans | $484.38 | $413.04 |
| North Carolina | $467.70 | $396.96 |
| North Dakota** | $485.55 | $409.73 |
| Northern Nj | $568.97 | $481.02 |
| Nyc Suburbs/Long Island | $601.47 | $511.32 |
| Ohio | $470.68 | $401.46 |
| Oklahoma | $457.02 | $389.31 |
| Oxnard-Thousand Oaks-Ventura | $560.71 | $471.09 |
| Portland | $536.97 | $452.73 |
| Poughkpsie/N Nyc Suburbs | $547.32 | $464.29 |
| Puerto Rico | $505.59 | $428.94 |
| Queens | $587.43 | $497.81 |
| Redding | $525.87 | $442.77 |
| Rest Of California | $525.87 | $442.77 |
| Rest Of Florida | $500.00 | $427.52 |
| Rest Of Georgia | $468.16 | $400.53 |
| Rest Of Illinois | $486.07 | $416.84 |
| Rest Of Louisiana | $459.14 | $392.04 |
| Rest Of Maine | $462.52 | $392.76 |
| Rest Of Maryland | $505.21 | $428.48 |
| Rest Of Massachusetts | $517.40 | $437.56 |
| Rest Of Michigan | $474.03 | $404.81 |
| Rest Of Missouri | $451.24 | $385.88 |
| Rest Of New Jersey | $542.54 | $459.74 |
| Rest Of New York | $475.65 | $403.62 |
| Rest Of Oregon | $492.33 | $416.81 |
| Rest Of Pennsylvania | $470.75 | $401.14 |
| Rest Of Texas | $480.83 | $408.87 |
| Rest Of Washington | $516.06 | $436.23 |
| Rhode Island | $513.11 | $434.79 |
| Riverside-San Bernardino-Ontario | $534.77 | $451.67 |
| Sacramento-Roseville-Folsom | $552.29 | $464.12 |
| Salinas | $550.29 | $462.41 |
| San Diego-Chula Vista-Carlsbad | $563.76 | $473.08 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $646.34 | $539.43 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $645.39 | $538.49 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $661.75 | $552.42 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $657.90 | $548.57 |
| San Luis Obispo-Paso Robles | $541.47 | $455.11 |
| Santa Cruz-Watsonville | $569.48 | $477.36 |
| Santa Maria-Santa Barbara | $552.49 | $464.08 |
| Santa Rosa-Petaluma | $575.20 | $482.10 |
| Seattle (King Cnty) | $584.86 | $491.83 |
| South Carolina | $470.29 | $400.23 |
| South Dakota** | $483.61 | $407.79 |
| Southern Maine | $488.52 | $413.38 |
| Stockton | $525.87 | $442.77 |
| Suburban Chicago | $533.99 | $456.13 |
| Tennessee | $456.17 | $387.25 |
| Utah | $477.42 | $406.15 |
| Vallejo | $609.40 | $509.46 |
| Vermont | $484.69 | $409.63 |
| Virgin Islands | $505.59 | $428.94 |
| Virginia | $487.70 | $413.17 |
| Visalia | $525.87 | $442.77 |
| West Virginia | $466.45 | $400.56 |
| Wisconsin | $467.60 | $394.96 |
| Wyoming** | $494.81 | $418.99 |
| Yuba City | $525.87 | $442.77 |
23545 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $568.93 | 1 |
| AL | $444.64 | 1 |
| AR | $437.42 | 1 |
| AZ | $486.78 | 1 |
| CA | $525.87–$661.75 | 29 |
| CO | $520.50 | 1 |
| CT | $538.00 | 1 |
| DC | $575.74 | 1 |
| DE | $495.42 | 1 |
| FL | $500.00–$559.28 | 3 |
| GA | $468.16–$513.73 | 2 |
| GU | $540.04 | 1 |
| HI | $540.04 | 1 |
| IA | $454.47 | 1 |
| ID | $458.39 | 1 |
| IL | $486.07–$540.51 | 4 |
| IN | $461.29 | 1 |
| KS | $453.44 | 1 |
| KY | $459.40 | 1 |
| LA | $459.14–$484.38 | 2 |
| MA | $517.40–$573.91 | 2 |
| MD | $505.21–$575.74 | 3 |
| ME | $462.52–$488.52 | 2 |
| MI | $474.03–$508.34 | 2 |
| MN | $493.02 | 1 |
| MO | $451.24–$484.66 | 3 |
| MS | $444.36 | 1 |
| MT | $501.96 | 1 |
| NC | $467.70 | 1 |
| ND | $485.55 | 1 |
| NE | $456.84 | 1 |
| NH | $513.42 | 1 |
| NJ | $542.54–$568.97 | 2 |
| NM | $477.48 | 1 |
| NV | $497.75 | 1 |
| NY | $475.65–$601.47 | 5 |
| OH | $470.68 | 1 |
| OK | $457.02 | 1 |
| OR | $492.33–$536.97 | 2 |
| PA | $470.75–$524.25 | 2 |
| PR | $505.59 | 1 |
| RI | $513.11 | 1 |
| SC | $470.29 | 1 |
| SD | $483.61 | 1 |
| TN | $456.17 | 1 |
| TX | $467.40–$520.12 | 8 |
| UT | $477.42 | 1 |
| VA | $487.70–$575.74 | 2 |
| VI | $505.59 | 1 |
| VT | $484.69 | 1 |
| WA | $516.06–$584.86 | 2 |
| WI | $467.60 | 1 |
| WV | $466.45 | 1 |
| WY | $494.81 | 1 |
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
Swap in your local Medicare rate.
Work 3.34Practice expense 10.86Malpractice 0.83
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 23545
AC joint treatment
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.
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
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).
23545 compared with similar codes
Compare codes
23545 vs 23540 vs 23550 vs 23552 vs 23525: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23540AC joint dislocation
- Both describe closed treatment of an AC dislocation; choose 23545 when manipulation is performed and 23540 when it is not.
- 23550AC joint repair
- This code is for closed treatment with manipulation. Code 23550 is for open treatment of the AC dislocation.
- 23552AC joint reconstruction
- This code describes closed manipulation. Code 23552 is used for open treatment involving a graft.
- 23525Joint reduction
- Both involve closed treatment with manipulation, but 23525 concerns a sternoclavicular dislocation, not an AC joint dislocation.
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
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