Billing code 23540: AC joint dislocationMedicare rate & RVUs in Texas
Reports nonoperative treatment of an acromioclavicular joint dislocation when the physician treats the injury without manipulating the joint.
Medicare pays $258.89–$285.48 for 23540 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
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 23540 covers
This service covers definitive nonoperative care for an acromioclavicular (AC) joint dislocation, the separation between the distal clavicle and the acromion. An orthopedic surgeon or other qualified physician may manage a traumatic AC separation with measures such as immobilization and a treatment plan that avoids joint manipulation. The code is specific to the AC joint, not a sternoclavicular dislocation or a clavicle fracture.
Report it when the physician assumes treatment of the dislocation without manipulating it; documentation should identify the injury and side, the treatment decision, and the nonoperative plan. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral treatment reported with modifier 50, CMS pays at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. 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 23540 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$258.89 to $285.48
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $285.48 | $264.63 |
| Beaumont | $258.89 | $240.96 |
| Brazoria | $271.92 | $252.39 |
| Dallas | $274.19 | $254.57 |
| Fort Worth | $272.57 | $253.14 |
| Galveston | $273.08 | $253.51 |
| Houston | $282.04 | $262.48 |
| Rest Of Texas | $265.62 | $246.92 |
How the 23540 rate is calculated
Each of 23540’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 · 23540
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.30Practice expense 5.49Malpractice 0.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 23540
23540 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23540
AC joint dislocation
| 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 · 23540
AC joint dislocation
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
23540 without 50 · national office
$276.56
AC joint dislocation
23540-50 · Bilateral: 150%
$414.84
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).
23540 compared with similar codes
Compare codes
23540 vs 23545 vs 23550 vs 23520 vs 23500: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 23545AC joint treatment
- Both address closed treatment of an AC dislocation; choose 23540 when treatment involves no manipulation and 23545 when the joint is manipulated.
- 23550AC joint repair
- This code describes nonoperative treatment without manipulation. Use 23550 when the AC dislocation is treated by an open procedure.
- 23520Sternoclavicular treatment
- This code concerns a sternoclavicular dislocation, at the joint between the sternum and clavicle. Code 23540 is for the acromioclavicular joint.
- 23500Clavicle fracture care
- This code is for a clavicle fracture, not an AC joint dislocation. Select according to the documented injury.
23540 billing questions
How is this code different from 23545?
Use 23540 when the AC dislocation is treated without manipulating the joint. Code 23545 is the corresponding closed-treatment option when manipulation is performed.
Does the global period include follow-up care?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported?
For treatment of both AC joints, report modifier 50. CMS pays bilateral reporting at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
What documentation supports reporting this service?
Document the AC joint dislocation, the affected side, the decision to manage it nonoperatively, and that the joint was not manipulated.
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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