$437.42
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 in Arkansas
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 in Arkansas.
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 in Arkansas?
Arkansas has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$242.77
1 of 1 localities have a supported rate.
Payment area: Arkansas
One mapped payment locality.
Facility setting
$225.84
1 of 1 localities have a supported rate.
Payment area: Arkansas
One mapped payment locality.
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.
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 rates for Arkansas, 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
This code concerns a sternoclavicular dislocation, at the joint between the sternum and clavicle. Code 23540 is for the acromioclavicular joint.
$226.74
This code is for a clavicle fracture, not an AC joint dislocation. Select according to the documented injury.
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.
1 of 1 payment localities
Arkansas →
Office / nonfacility
$242.77
Facility
$225.84
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 23540 in Arkansas.
PPRRVU2026_Oct_nonQPP.csv
2,225
- Code
- 23540
- Physician work
- 2.30
- Practice expense
- 5.49
- Malpractice
- 0.49
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.30 | × 1.000 | 2.3000 |
| Practice expense | 5.49 | × 0.859 | 4.7159 |
| Malpractice | 0.49 | × 0.515 | 0.2524 |
| Total RVUs | 7.2683 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Arkansas$242.77
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.3 | 1 |
| Practice expense | 5.49 | 0.859 |
| Malpractice | 0.49 | 0.515 |
(2.3 × 1 + 5.49 × 0.859 + 0.49 × 0.515) × $33.4009 = $242.77
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.3 | 1 |
| Practice expense | 4.9 | 0.859 |
| Malpractice | 0.49 | 0.515 |
(2.3 × 1 + 4.9 × 0.859 + 0.49 × 0.515) × $33.4009 = $225.84
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541