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Billing code 23700: Shoulder manipulationMedicare rate & RVUs

Reports manipulation of a stiff shoulder joint under general anesthesia, including fixation apparatus when used, to restore motion without arthroscopic release.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.4K Medicare services in 2024

Medicare pays $184.71 for 23700 nationally in a facility.

Medicare rate · 23700

Shoulder manipulation

Work RVUs
2.51
Total RVUs
5.53
Global days
010

National rate · 2026

$184.71

Facility setting, before claim adjustments.

See every locality for 23700 →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
  1. Medicare rate
  2. What 23700 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 23700 covers

The surgeon moves the shoulder joint through its range while the patient is under general anesthesia to address substantial stiffness, commonly from adhesive capsulitis. The procedure is typically performed in an operating room or ambulatory surgery setting; the surgeon performs the manipulation and an anesthesia professional provides general anesthesia. The code includes application of fixation apparatus when used. It is distinct from arthroscopic capsular release, which involves operative visualization and tissue release.

Report 23700 for the shoulder manipulation itself, not simply for administering anesthesia or documenting limited motion. The operative note should identify the affected shoulder, the indication, the manipulation performed, and any fixation apparatus applied. CMS assigns a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 23700 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

23700 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$167.04
Alaska*Unavailable$224.77
ArizonaUnavailable$179.73
ArkansasUnavailable$164.85
AtlantaUnavailable$189.60
AustinUnavailable$187.91
BakersfieldUnavailable$188.01
Baltimore/Surr. CntysUnavailable$196.10
BeaumontUnavailable$175.94
BrazoriaUnavailable$181.02

23700 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
23700 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 23700 rate is calculated

Each of 23700’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 · 23700

RVUs × geographic indexes × conversion factor

Work2.51

2.51 RVUs× 1.000 GPCI

Practice expense2.53

2.53 RVUs× 1.000 GPCI

Malpractice0.49

0.49 RVUs× 1.000 GPCI

Adjusted RVUs

5.5300

Conversion factor

$33.4009

Medicare rate

$184.71

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

Payment rules and modifiers for 23700

23700 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 23700

Shoulder manipulation

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 23700

Shoulder manipulation

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

23700 without 50 · national facility

$184.71

Shoulder manipulation

23700-50 · Bilateral: 150%

$277.07

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

23700 compared with similar codes

Compare codes · National

4 codes, side by side

  • 23700

    Shoulder manipulation2.51 wRVU

    Not priced

  • 29825

    Shoulder arthroscopy7.6 wRVU

    Not priced

  • 23655

    Shoulder reduction4.64 wRVU

    Not priced

  • 20610

    Joint injection0.77 wRVU

    $68.81

How to choose

29825Shoulder arthroscopy
Choose 23700 for manipulation under general anesthesia. Choose 29825 when the surgeon performs arthroscopic capsular release.
23655Shoulder reduction
Code 23655 concerns closed treatment of a shoulder dislocation requiring manipulation. Code 23700 addresses manipulation of a stiff shoulder joint.
20610Joint injection
Code 20610 reports aspiration or injection of a major joint. It does not represent manipulation to restore shoulder motion.

Codes related to 23700

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

Codes related to 23700
CodeHow it relatesNational office range
Used instead
29825Shoulder arthroscopyArthroscopic capsular release treats shoulder stiffness using operative release rather than manipulation alone.No office rate
23655Shoulder reductionClosed treatment involving manipulation is used for shoulder dislocation, not stiffness alone.No office rate
Often billed with
20610Joint injectionA separately performed major-joint aspiration or injection may accompany shoulder manipulation when documented.$61.24–$86.75

23700 billing questions

When should 23700 be chosen over arthroscopic capsular release?

Use 23700 when the surgeon restores shoulder motion by manipulation under general anesthesia. Arthroscopic capsular release involves surgical release of the capsule under arthroscopic visualization.

What documentation supports reporting 23700?

Document the shoulder and side treated, the reason for stiffness, the manipulation performed, and any fixation apparatus applied. The record should support that the shoulder was manipulated under general anesthesia.

How are bilateral shoulder procedures reported?

For bilateral reporting, use modifier 50; CMS pays the bilateral procedure at 150%. Document the procedure performed on each shoulder.

Are postoperative visits separately reported during the global period?

Related postoperative visits during the 10-day global period are included in 23700.

Can an assistant or co-surgeon be reported?

CMS does not pay for an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

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 23700PPRRVU2026_Oct_nonQPP.csv, line 2,246 (RVU26D)

Open CMS sourceHow we calculate rates

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