No office rate
Choose 23552 when the open acromioclavicular reconstruction uses a graft. Choose 23550 for open treatment without a graft.
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CMS RVU26D · Effective 2026-10-01
23552 AC joint reconstruction Medicare reimbursement rates in Delaware
Open reconstruction of an acromioclavicular separation using a graft, reported when operative treatment addresses an acute or chronic dislocation. Compare 23552 office and facility rates across CMS payment localities in Delaware.
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 23552 in Delaware?
Delaware 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
No supported rate
Facility setting
$604.75
1 of 1 localities have a supported rate.
Payment area: Delaware
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 23552: Open acromioclavicular reconstruction with graft
Open reconstruction of an acromioclavicular separation using a graft, reported when operative treatment addresses an acute or chronic dislocation.
An orthopedic surgeon uses an open approach to reduce and reconstruct a dislocated acromioclavicular joint with a graft. The procedure may be performed for an acute separation or a chronic separation requiring operative reconstruction; the graft helps restore support across the joint. The code applies to the acromioclavicular joint, where the clavicle meets the acromion, not the sternoclavicular joint or a clavicle fracture.
Report this code when the operative record supports open treatment of the acromioclavicular dislocation and graft use. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 23552
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.60 · 47%
- Practice expense (office) RVU8.04 · 44%
- Malpractice RVU1.69 · 9%
371
Medicare services in 2024 · #3794 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.
23552 compared with similar codes
Office rates for Delaware, from the same CMS release.
$495.42
This code describes open graft reconstruction; 23545 is closed treatment of an acromioclavicular dislocation with manipulation.
No office rate
Both involve graft-assisted open treatment of a dislocation, but 23532 addresses the sternoclavicular joint; this code addresses the acromioclavicular joint.
Compare 23552 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
Delaware →
Office / nonfacility
Unavailable
Facility
$604.75
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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 23552 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,228
- Code
- 23552
- Physician work
- 8.60
- Practice expense
- 8.04
- Malpractice
- 1.69
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.60 | × 1.005 | 8.6430 |
| Practice expense | 8.04 | × 0.988 | 7.9435 |
| Malpractice | 1.69 | × 0.899 | 1.5193 |
| Total RVUs | 18.1058 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$604.75
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.6 | 1.005 |
| Practice expense | 8.04 | 0.988 |
| Malpractice | 1.69 | 0.899 |
(8.6 × 1.005 + 8.04 × 0.988 + 1.69 × 0.899) × $33.4009 = $604.75
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.
23552 billing questions
How is this code different from 23550?
Both describe open treatment of an acromioclavicular dislocation. Use 23552 when the operative treatment includes a graft; 23550 is the related option without a graft.
Does the code include harvesting the graft?
The graft reconstruction is part of the service. Document the graft used and the open treatment performed; do not assume a separately reportable harvest service from the graft use alone.
When should 23545 be considered instead?
23545 is for closed treatment of an acromioclavicular dislocation with manipulation. This code is for open treatment with graft reconstruction.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
Can this be reported for both shoulders?
For bilateral treatment, CMS pays the procedure with modifier 50 at 150%. The operative documentation should support treatment of both sides.
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.
2,22523540,,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
2,22923570,,Cltx scapular fx w/o mnpj,A,,2.30,5.19,,4.80,,0.47,7.96,7.57,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23023575,,Cltx scap fx w/mnpj +-tractj,A,,4.12,8.74,,6.35,,0.88,13.74,11.35,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23123585,,Optx scapular fx w/int fixj,A,,13.87,10.12,NA,10.12,,2.82,26.81,26.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503