Billing code 23655: Shoulder reductionMedicare rate & RVUs in Massachusetts
Report this service for closed reduction of a shoulder dislocation when manipulation requires anesthesia, rather than reduction without anesthesia or operative treatment.
CMS doesn’t publish an office rate for 23655 in Massachusetts.
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 9 sections
What 23655 covers
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.
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 23655 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | Unavailable | $466.03 |
| Rest Of Massachusetts | Unavailable | $426.59 |
How the 23655 rate is calculated
Each of 23655’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 · 23655
RVUs × geographic indexes × conversion factor
Work4.64
4.64 RVUs× 1.000 GPCI
Practice expense6.88
6.88 RVUs× 1.000 GPCI
Malpractice1.02
1.02 RVUs× 1.000 GPCI
Adjusted RVUs
12.5400
Conversion factor
$33.4009
Medicare rate
$418.85
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 23655
23655 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23655
Shoulder reduction
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 23655
Shoulder reduction
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
23655 without 50 · national facility
$418.85
Shoulder reduction
23655-50 · Bilateral: 150%
$628.28
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).
23655 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 23650Shoulder reduction
- Both describe closed shoulder dislocation reduction. Choose 23655 when manipulation requires anesthesia; choose 23650 when it does not.
- 23660Shoulder dislocation
- Code 23660 is for operative treatment of an acute shoulder dislocation. Code 23655 is for reduction by closed manipulation.
- 23665Shoulder reduction
- Code 23665 addresses a shoulder dislocation with a greater tuberosity fracture; 23655 describes a dislocation without that fracture-specific treatment.
- 23675Shoulder reduction
- Code 23675 applies to a shoulder dislocation with a surgical neck fracture, while 23655 covers closed reduction of the dislocation without that fracture-specific treatment.
23655 billing questions
How does 23655 differ from 23650?
Use 23655 when the closed manipulation requires anesthesia. Code 23650 describes closed manipulation without anesthesia.
Should 23655 be reported for an open reduction?
No. Code 23655 describes closed manipulation; operative treatment of an acute shoulder dislocation is represented by 23660.
What documentation supports 23655?
Document the shoulder dislocation, affected side, closed reduction performed, and the need for anesthesia during manipulation.
How is a bilateral service handled?
CMS identifies this as a bilateral procedure; when modifier 50 is used, payment is at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be paid?
CMS lists a statutory restriction on assistant-at-surgery payment for this code and does not permit co-surgeons or team surgery.
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
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