No office rate
Both are closed manipulations for shoulder dislocation; 23650 is for reduction without anesthesia, while 23655 is for reduction with anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
23650 Shoulder reduction Medicare reimbursement rates in Minnesota
Reports closed manipulation to reduce a shoulder dislocation when the reduction is performed without anesthesia, such as in an emergency department or office. Compare 23650 office and facility rates across CMS payment localities in Minnesota.
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 23650 in Minnesota?
Minnesota 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
$423.05
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$355.00
1 of 1 localities have a supported rate.
Payment area: Minnesota
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 23650: Closed shoulder dislocation reduction without anesthesia
Reports closed manipulation to reduce a shoulder dislocation when the reduction is performed without anesthesia, such as in an emergency department or office.
This service covers closed manipulation to restore alignment after a shoulder dislocation, without anesthesia. A common situation is an emergency physician or orthopedic surgeon reducing an uncomplicated glenohumeral dislocation in an emergency department; the service may also occur in an office or other appropriate setting. The code is for a dislocation treated by manipulation, not a proximal humeral fracture treated as a fracture or an open reduction.
Report the code when the shoulder is reduced by manipulation and anesthesia is not used for the procedure; the anesthesia distinction separates it from 23655. Document the dislocation, side, manipulation and reduction performed, and anesthesia status. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 23650
- 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 RVU3.44 · 26%
- Practice expense (office) RVU8.73 · 67%
- Malpractice RVU0.82 · 6%
12.7K
Medicare services in 2024 · #1349 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.
23650 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$483.91
Use 23665 for a shoulder dislocation accompanied by a greater tuberosity fracture treated closed, rather than an isolated dislocation.
No office rate
23660 describes open treatment of an acute shoulder dislocation; 23650 describes closed manipulation without anesthesia.
$374.38
23600 is closed treatment of a proximal humeral fracture without manipulation, not closed reduction of a shoulder dislocation.
Compare 23650 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
Minnesota →
Office / nonfacility
$423.05
Facility
$355.00
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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 23650 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
2,239
- Code
- 23650
- Physician work
- 3.44
- Practice expense
- 8.73
- Malpractice
- 0.82
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.44 | × 1.000 | 3.4400 |
| Practice expense | 8.73 | × 1.029 | 8.9832 |
| Malpractice | 0.82 | × 0.296 | 0.2427 |
| Total RVUs | 12.6659 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$423.05
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.44 | 1 |
| Practice expense | 8.73 | 1.029 |
| Malpractice | 0.82 | 0.296 |
(3.44 × 1 + 8.73 × 1.029 + 0.82 × 0.296) × $33.4009 = $423.05
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.44 | 1 |
| Practice expense | 6.75 | 1.029 |
| Malpractice | 0.82 | 0.296 |
(3.44 × 1 + 6.75 × 1.029 + 0.82 × 0.296) × $33.4009 = $355.00
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.
23650 billing questions
How does 23650 differ from 23655?
Both describe closed manipulation of a shoulder dislocation. Use 23650 when the reduction is performed without anesthesia and 23655 when anesthesia is used.
Does a dislocation with a humeral fracture belong under this code?
A dislocation accompanied by a specified humeral fracture may fall under a separate fracture-dislocation code, such as 23665 for a greater tuberosity fracture. Choose based on the documented injury and treatment, not the dislocation alone.
What should the record show?
Document the affected side, the shoulder dislocation, the manipulation and reduction performed, and whether anesthesia was used. These details support the code and distinguish it from fracture-dislocation treatment.
How is bilateral treatment reported?
When both shoulders are treated, report bilateral services with modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or another surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
2,23623620,,Cltx gr hmrl tbrs fx wo mnpj,A,,2.49,6.28,,5.14,,0.50,9.27,8.13,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23723625,,Cltx gr hmrl tbrs fx w/mnpj,A,,4.00,8.54,,6.42,,0.88,13.42,11.30,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23823630,,Optx gr hmrl tbrs fx int fix,A,,10.31,9.56,NA,9.56,,2.11,21.98,21.98,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,23923650,,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
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002