23655 Shoulder reduction Medicare reimbursement rates in California

Code 23655 represents closed reduction of a shoulder dislocation when the reduction requires anesthesia. The clinician manipulates the humeral head back into the glenoid without opening the joint. An orthopedic surgeon or emergency physician may perform the reduction in an operating room, procedure area, or emergency setting with anesthesia support. This is distinct from a reduction performed without anesthesia and from operative treatment of the dislocation.

Select the code based on the treatment actually performed, not simply the setting or the fact that anesthesia was available. Documentation should identify the dislocation, side, closed manipulation, and that anesthesia was required for the reduction. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 for a bilateral procedure is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.