$392.30
23650 is for a shoulder dislocation treated by closed manipulation without the greater tuberosity fracture described by 23665.
On this page
CMS RVU26D · Effective 2026-10-01
23665 Shoulder reduction Medicare reimbursement rates in Kansas
Reports closed manipulation of a shoulder dislocation accompanied by a greater tuberosity fracture, with closed treatment of the fracture included. Compare 23665 office and facility rates across CMS payment localities in Kansas.
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 23665 in Kansas?
Kansas 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
$451.70
1 of 1 localities have a supported rate.
Payment area: Kansas
One mapped payment locality.
Facility setting
$377.72
1 of 1 localities have a supported rate.
Payment area: Kansas
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 treatment
About 23665: Closed shoulder dislocation and tuberosity fracture treatment
Reports closed manipulation of a shoulder dislocation accompanied by a greater tuberosity fracture, with closed treatment of the fracture included.
This code describes closed treatment of a shoulder dislocation when the injury also includes a fracture of the greater tuberosity of the humerus. The physician manipulates the shoulder to restore alignment and treats the associated fracture without open surgery. Orthopedic surgeons commonly provide this service after an acute injury, such as a fall or sports-related trauma, in an emergency department or operating room setting.
Report the code when documentation supports both the shoulder dislocation and greater tuberosity fracture, along with closed treatment involving manipulation. Treatment of the fracture is included; do not separately report a second closed-treatment service for that fracture. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 23665
- 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 RVU4.54 · 30%
- Practice expense (office) RVU9.38 · 63%
- Malpractice RVU1.00 · 7%
269
Medicare services in 2024 · #4078 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.
23665 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
23655 addresses closed manipulation of a shoulder dislocation without an associated greater tuberosity fracture and specifies anesthesia.
$570.69
Choose 23675 when the associated fracture is at the humeral surgical neck; 23665 is for a greater tuberosity fracture.
No office rate
23670 is the open-treatment option for a shoulder dislocation with fracture; 23665 describes closed treatment with manipulation.
Compare 23665 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
Kansas →
Office / nonfacility
$451.70
Facility
$377.72
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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 23665 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
2,242
- Code
- 23665
- Physician work
- 4.54
- Practice expense
- 9.38
- Malpractice
- 1.00
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.54 | × 1.000 | 4.5400 |
| Practice expense | 9.38 | × 0.904 | 8.4795 |
| Malpractice | 1.00 | × 0.504 | 0.5040 |
| Total RVUs | 13.5235 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kansas$451.70
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.54 | 1 |
| Practice expense | 9.38 | 0.904 |
| Malpractice | 1 | 0.504 |
(4.54 × 1 + 9.38 × 0.904 + 1 × 0.504) × $33.4009 = $451.70
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.54 | 1 |
| Practice expense | 6.93 | 0.904 |
| Malpractice | 1 | 0.504 |
(4.54 × 1 + 6.93 × 0.904 + 1 × 0.504) × $33.4009 = $377.72
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.
23665 billing questions
Does this code include treatment of the greater tuberosity fracture?
Yes. The code includes closed treatment of the fracture along with closed manipulation of the shoulder dislocation; do not separately report another closed-treatment service for that fracture.
How does this differ from 23650 or 23655?
Those codes describe closed manipulation of a shoulder dislocation without the associated greater tuberosity fracture. Use 23665 when the dislocation and greater tuberosity fracture are both part of the injury being treated.
When is 23675 the better choice?
Use 23675 for a shoulder dislocation associated with a fracture of the humeral surgical neck. This code is for an associated greater tuberosity fracture.
Can the fracture treatment be billed separately?
The closed treatment of the greater tuberosity fracture is included in this service. Documentation should establish the dislocation, fracture location, and manipulation performed.
What does the 90-day global period include?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are bilateral cases and surgical assistance handled?
CMS pays bilateral procedures reported with modifier 50 at 150%. Assistant-at-surgery payment is statutorily restricted, and 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 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.
2,23923650,,Cltx sho dslc w/mnpj wo anes,A,,3.44,8.73,,6.75,,0.82,12.99,11.01,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24023655,,Cltx sho dslc w/mnpj w/anes,A,,4.64,6.88,NA,6.88,,1.02,12.54,12.54,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24123660,,Optx acute shoulder dislc,A,,7.47,7.55,NA,7.55,,1.48,16.50,16.50,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24223665,,Cltx sho dslc fx gr hmrl tbr,A,,4.54,9.38,,6.93,,1.00,14.92,12.47,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24323670,,Optx sho dislc fx,A,,11.97,9.99,NA,9.99,,2.52,24.48,24.48,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24423675,,Cltx sho dislc neck fx mnpj,A,,6.11,11.40,,7.86,,1.33,18.84,15.30,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,24523680,,Optx sho dislc neck fx fixj,A,,12.82,10.35,NA,10.35,,2.73,25.90,25.90,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958