Billing code 23700: Shoulder manipulationMedicare rate & RVUs in Oregon
Reports manipulation of a stiff shoulder joint under general anesthesia, including fixation apparatus when used, to restore motion without arthroscopic release.
CMS doesn’t publish an office rate for 23700 in Oregon.
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 23700 covers
The surgeon moves the shoulder joint through its range while the patient is under general anesthesia to address substantial stiffness, commonly from adhesive capsulitis. The procedure is typically performed in an operating room or ambulatory surgery setting; the surgeon performs the manipulation and an anesthesia professional provides general anesthesia. The code includes application of fixation apparatus when used. It is distinct from arthroscopic capsular release, which involves operative visualization and tissue release.
Report 23700 for the shoulder manipulation itself, not simply for administering anesthesia or documenting limited motion. The operative note should identify the affected shoulder, the indication, the manipulation performed, and any fixation apparatus applied. CMS assigns a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 23700 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $191.24 |
| Rest Of Oregon | Unavailable | $179.51 |
How the 23700 rate is calculated
Each of 23700’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 · 23700
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.51Practice expense 2.53Malpractice 0.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23700
23700 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23700
Shoulder manipulation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 23700
Shoulder manipulation
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
23700 without 50 · national facility
$184.71
Shoulder manipulation
23700-50 · Bilateral: 150%
$277.07
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).
23700 compared with similar codes
Compare codes
23700 vs 29825 vs 23655 vs 20610: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 29825Shoulder arthroscopy
- Choose 23700 for manipulation under general anesthesia. Choose 29825 when the surgeon performs arthroscopic capsular release.
- 23655Shoulder reduction
- Code 23655 concerns closed treatment of a shoulder dislocation requiring manipulation. Code 23700 addresses manipulation of a stiff shoulder joint.
- 20610Joint injection
- Code 20610 reports aspiration or injection of a major joint. It does not represent manipulation to restore shoulder motion.
23700 billing questions
When should 23700 be chosen over arthroscopic capsular release?
Use 23700 when the surgeon restores shoulder motion by manipulation under general anesthesia. Arthroscopic capsular release involves surgical release of the capsule under arthroscopic visualization.
What documentation supports reporting 23700?
Document the shoulder and side treated, the reason for stiffness, the manipulation performed, and any fixation apparatus applied. The record should support that the shoulder was manipulated under general anesthesia.
How are bilateral shoulder procedures reported?
For bilateral reporting, use modifier 50; CMS pays the bilateral procedure at 150%. Document the procedure performed on each shoulder.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in 23700.
Can an assistant or co-surgeon be reported?
CMS does not pay for an assistant at surgery for this code. 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 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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