{"id":180981,"date":"2026-08-17T08:28:29","date_gmt":"2026-08-17T08:28:29","guid":{"rendered":"https:\/\/pabau.com\/?p=180981"},"modified":"2026-08-17T09:11:51","modified_gmt":"2026-08-17T09:11:51","slug":"cpt-code-23650","status":"publish","type":"post","link":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/","title":{"rendered":"CPT code 23650: Closed treatment of shoulder dislocation, without anesthesia"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 23650: Closed treatment of shoulder dislocation, without anesthesia\",\"description\":\"CPT Code 23650 covers closed treatment of shoulder dislocation with manipulation, without anesthesia. Learn 2026 Medicare rates, modifiers, ICD-10 pairings, and documentation requirements.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-23650\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-17\",\"dateModified\":\"2026-08-17\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT code 23650 covers closed treatment of a shoulder dislocation with manipulation, performed without any anesthetic agent.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The 2026 Medicare national rate is roughly $434 in a non-facility setting and $368 in a facility.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Always apply a laterality modifier, either -RT or -LT, on every 23650 claim you submit.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Billing 23650 after anesthesia was given is an upcoding risk, so use CPT 23655 instead.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau validates code and modifier pairs before submission, which cuts shoulder dislocation denials.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">The official AMA descriptor for CPT code 23650 is: Closed treatment of shoulder dislocation, with manipulation, without anesthesia.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The code applies when a clinician manually reduces a dislocated glenohumeral joint without any anesthetic agent. The patient stays conscious throughout. Common reduction maneuvers include the Cunningham technique, the modified Milch, and external rotation. No incision is made, and the joint returns to position through controlled force and positioning alone.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This code sits in the Musculoskeletal System section of the <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">AMA CPT code set<\/a>, under shoulder fractures and dislocations. It is billed in emergency departments, orthopedic offices, <a href=\"https:\/\/pabau.com\/industry\/sports-medicine-software\/\">sports medicine practices<\/a>, and urgent care. The procedure covers anterior, posterior, and inferior glenohumeral dislocations treated without sedation or a regional nerve block.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The single differentiator for 23650 is that <strong>no anesthetic agent of any type was used<\/strong>. If IV sedation, a regional block, or general anesthesia was administered, the correct code is CPT 23655.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-cpt-23650-vs-cpt-23655-key-differences\" class=\"wp-block-heading\">CPT 23650 vs CPT 23655: Key differences<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The boundary between 23650 and 23655 is the most common source of upcoding risk in shoulder dislocation billing. The table below shows when each code applies.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Factor<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT 23650<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT 23655<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Anesthesia<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None (conscious patient)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Requires anesthetic agent<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Setting<\/td>\n<td style=\"padding:12px 16px;color:#374151\">ED, urgent care, office<\/td>\n<td style=\"padding:12px 16px;color:#374151\">ED with sedation, ASC, OR<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Documentation trigger<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Record must confirm no anesthetic<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia or sedation type must be documented<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">2026 Medicare non-facility rate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$434<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Higher, reflecting anesthesia complexity<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Upcoding risk<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Using 23655 when no anesthesia given<\/td>\n<td style=\"padding:12px 16px;color:#374151\">N\/A (23655 is the higher-value code)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">When a separate anesthesia provider handles the sedation for 23655, that service is reported on its own under <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-01620\/\">01620<\/a>.<\/p>\n\n\n\n<h2 id=\"h-icd-10-codes-commonly-paired-with-cpt-23650\" class=\"wp-block-heading\">ICD-10 codes commonly paired with CPT 23650<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Every CPT 23650 claim needs a supporting ICD-10-CM diagnosis code. The right code depends on the direction of the dislocation, the side, and the encounter type. Use the seventh character \u00ab\u00a0A\u00a0\u00bb for the initial treatment visit. Wrong laterality is a leading cause of denial on this procedure.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Encounter<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S43.006A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unspecified dislocation of unspecified shoulder joint, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial (A)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S43.014A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anterior dislocation of right humerus, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial (A)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S43.015A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anterior dislocation of left humerus, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial (A)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S43.024A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Posterior dislocation of right humerus, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial (A)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S43.025A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Posterior dislocation of left humerus, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial (A)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S43.036A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Inferior dislocation of unspecified humerus, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial (A)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S43.084A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other dislocation of right humerus, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Initial (A)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Laterality guidance:<\/strong> Always code the specific side when the note documents it. The codes ending in 6 are the unspecified-side options, so they are a last resort. Payers increasingly deny them where the side is clinically determinable. At follow-up the seventh character changes, so <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s43014d\/\">S43.014D<\/a> replaces S43.014A once active treatment ends.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Verify the seventh character before you submit. &lsquo;A&rsquo; applies during active treatment. Once the patient moves to routine healing care, it changes to &lsquo;D&rsquo; for subsequent or &lsquo;S&rsquo; for sequela. Billing 23650 with a &lsquo;D&rsquo; code on the reduction date will trigger an edit.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-cpt-23650-reimbursement-medicare-rates-for-2026\" class=\"wp-block-heading\">CPT 23650 reimbursement: Medicare rates for 2026<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare pays roughly $434 for CPT 23650 in a non-facility setting and $368 in a facility. Those national figures come from the 2026 conversion factor of $33.4009 applied to total RVUs of 12.99 and 11.01.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Confirm the rate for your own locality with the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule lookup<\/a> or the <a href=\"https:\/\/fastrvu.com\/tools\/rvu-lookup\" target=\"_blank\" rel=\"nofollow noopener\">FastRVU 2026 RVU lookup<\/a>. Your MAC&rsquo;s published rates are the final word.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Rate type<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">2026 national rate (approx.)<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Setting<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Non-facility rate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$434 (12.99 total RVUs)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician office, urgent care<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Facility rate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$368 (11.01 total RVUs)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hospital ED, ASC, inpatient<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h3 id=\"h-facility-vs-non-facility-payment-rates\" class=\"wp-block-heading\">Facility vs non-facility payment rates<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The difference reflects the practice expense component of the RVU calculation. In a physician office or urgent care, the practice absorbs the overhead directly, so the non-facility rate is higher.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When the reduction happens in a hospital ED or ASC, the facility bills its own overhead separately. The physician&rsquo;s payment drops to the lower facility rate as a result.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Each RVU component carries its own geographic practice cost index, or GPCI, for your locality. The three components are work, practice expense, and malpractice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Multiply each component by its GPCI, add the results, then multiply by the conversion factor. That gives your locality-adjusted payment. <a href=\"https:\/\/pabau.com\/blog\/medicare-billing\/\">Medicare billing<\/a> rules shift from year to year, so re-check the factor every January.<\/p>\n\n\n\n<h2 id=\"h-modifiers-for-cpt-code-23650\" class=\"wp-block-heading\">Modifiers for CPT code 23650<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier selection for 23650 depends on the setting, the laterality, and whether other services happened the same day. <a href=\"https:\/\/pabau.com\/industry\/physical-therapy-emr\/\">Physical therapy practices<\/a> and orthopedic offices see the most modifier disputes when laterality is left off. The table below covers every modifier that applies to this code.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to use<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Procedure performed on the right shoulder (mandatory)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-LT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Procedure performed on the left shoulder (mandatory)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-50<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bilateral procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Both shoulders reduced in one session (rare, payer rules vary)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-51<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Second surgical procedure in the same session (check NCCI edits first)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-59<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Distinct procedural service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Override an NCCI bundling edit when the services are genuinely distinct<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-76<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Repeat procedure by same physician<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Repeat reduction in the same session by the same provider<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-77<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Repeat procedure by different physician<\/td>\n<td style=\"padding:12px 16px;color:#374151\">A different provider repeats the reduction in the same session<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Payer-specific note:<\/strong> Medicare Administrative Contractors, known as MACs, publish local coverage determinations that can override national modifier guidance. Confirm your MAC&rsquo;s requirements before billing -50 for a bilateral shoulder reduction. Some MACs want two line items, -RT and -LT, instead of a single -50.<\/p>\n\n\n\n<h2 id=\"h-documentation-requirements-for-cpt-23650\" class=\"wp-block-heading\">Documentation requirements for CPT 23650<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Incomplete documentation is the main reason 23650 claims fail post-payment audits. The record has to support all three elements of the descriptor: closed treatment, manipulation, and no anesthesia. <a href=\"https:\/\/pabau.com\/features\/patient-intake-software\/\">Digital intake forms<\/a> that prompt for those fields save coders from digging through free-text notes.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-23650\/customizable-consent-and-intake-forms.webp\" alt=\"Customizable consent and intake forms\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&rsquo;s customizable intake forms capture laterality and anesthesia status at the point of care, so the coder never has to guess.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">These elements support a clean 23650 claim:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Clinical indication:<\/strong> a documented diagnosis of shoulder dislocation, including the direction and the side<\/li>\n\n\n\n<li><strong>Technique performed:<\/strong> the specific reduction maneuver used, such as Cunningham, Milch, Kocher, or external rotation<\/li>\n\n\n\n<li><strong>Absence of anesthesia:<\/strong> an explicit statement that no anesthetic agent, IV sedation, or regional nerve block was given<\/li>\n\n\n\n<li><strong>Neurovascular status:<\/strong> pre- and post-reduction checks of distal pulses, motor function, and sensation<\/li>\n\n\n\n<li><strong>Post-reduction imaging:<\/strong> confirmation that the reduction succeeded, documented separately if the X-ray is billed<\/li>\n\n\n\n<li><strong>Immobilization applied:<\/strong> the device fitted after reduction, such as a sling or Velpeau bandage. A supplied axilla sling carries its own code, <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-l1010\/\">L1010<\/a><\/li>\n\n\n\n<li><strong>Patient response:<\/strong> pain level, cooperation during the maneuver, and the outcome of the procedure<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Missing the anesthesia statement is the single most common audit finding<\/strong> for this code. A note that records the technique but says nothing about anesthesia lets the payer assume anesthesia was used. That assumption triggers a downcode or a denial.<\/p>\n\n\n\n<h2 id=\"h-common-coding-errors-and-audit-risks\" class=\"wp-block-heading\">Common coding errors and audit risks<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The OIG Work Plan and MAC audit reports repeatedly flag shoulder dislocation codes for billing irregularities. These five errors recur most often with CPT 23650.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Upcoding to 23655:<\/strong> billing the anesthesia variant when the record shows a conscious patient and no sedation. This is an OIG priority target for orthopedic and ED providers.<\/li>\n\n\n\n<li><strong>Missing laterality modifier:<\/strong> submitting 23650 without -RT or -LT. Medicare and most commercial payers will deny the claim or return it for more information.<\/li>\n\n\n\n<li><strong>Unbundling post-reduction imaging:<\/strong> billing CPT 73030 on the same date needs documentation that the X-ray was separately ordered and performed. Some payers treat it as bundled into the initial ED encounter.<\/li>\n\n\n\n<li><strong>E\/M on the same date without -25:<\/strong> modifier -25 belongs on the E\/M code, never on 23650. Leave it off and the E\/M is denied as a duplicate.<\/li>\n\n\n\n<li><strong>Wrong encounter designator:<\/strong> pairing 23650 with a \u00ab\u00a0D\u00a0\u00bb diagnosis code on the day of the reduction. Initial treatment takes the \u00ab\u00a0A\u00a0\u00bb seventh character.<\/li>\n<\/ul>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Run a quarterly audit of your 23650 claims against your MAC&rsquo;s local coverage determination. Filter for claims returned for a missing modifier or for ICD-10 specificity. Both edit types are preventable with a pre-submission check, so track how many you see each quarter.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-related-cpt-codes-in-the-shoulder-dislocation-series\" class=\"wp-block-heading\">Related CPT codes in the shoulder dislocation series<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The 2365x family covers the full spectrum of shoulder dislocation treatment. Use the <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC Codify CPT lookup<\/a> to confirm current descriptors and any annual changes.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Descriptor<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key differentiator<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">23650<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Closed treatment of shoulder dislocation, with manipulation, without anesthesia<\/td>\n<td style=\"padding:12px 16px;color:#374151\">No anesthetic used<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">23655<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Closed treatment of shoulder dislocation, with manipulation, requiring anesthesia<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia or IV sedation required<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">23665<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture-dislocation reduced closed<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">23670<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation when performed<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open surgical treatment, fixation when performed<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Use a <a href=\"https:\/\/crosscoder.com\/\" target=\"_blank\" rel=\"nofollow noopener\">CPT-to-ICD crosswalk tool<\/a> to confirm medical necessity across the family. Crosswalk checks matter most when imaging finds a greater tuberosity fracture after the reduction. That finding moves the claim to <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-23670\/\">23670<\/a> when the shoulder goes on to open treatment.<\/p>\n\n\n\n<h2 id=\"h-how-practice-management-software-streamlines-cpt-23650-billing\" class=\"wp-block-heading\">How practice management software streamlines CPT 23650 billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most 23650 denials start after the clinical work is finished, in the handoff between the note and the submitted claim. Three workflow failures drive the majority of them:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Missing modifier at entry:<\/strong> the coder picks 23650, but nothing prompts for laterality. The claim ships without -RT or -LT and comes back for correction.<\/li>\n\n\n\n<li><strong>ICD-10 mismatch:<\/strong> the system accepts S43.006A even though the note documents a right shoulder. Payers increasingly deny unspecified codes on lateralized procedures.<\/li>\n\n\n\n<li><strong>Anesthesia field left blank:<\/strong> the note template never captures anesthesia status, so the coder re-reads the whole note to choose between 23650 and 23655.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau handles these checks at the point of claim creation. Our <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management software<\/a> validates CPT and ICD-10 pairs and flags a missing laterality modifier before submission. It also surfaces the anesthesia field during coding review, so the coder can confirm 23650 in seconds.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For <a href=\"https:\/\/pabau.com\/blog\/hipaa-compliance-software\/\">HIPAA-compliant billing<\/a>, that means fewer manual checks and a shorter denial-resolution cycle. Automated recalls and follow-up scheduling keep the record current across a multi-visit musculoskeletal episode.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Post-reduction instructions go out from the same record, so sling advice and follow-up dates reach the patient without a second system. Strong <a href=\"https:\/\/pabau.com\/blog\/patient-education\/\">patient education<\/a> also cuts avoidable calls to the front desk.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-23650\/automate-claims-through-healthcode.webp\" alt=\"Automate claims and billing with Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&rsquo;s claims dashboard flags a 23650 claim that is missing its -RT or -LT modifier before it reaches the payer.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Reduce shoulder dislocation denials with automated code checks                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&rsquo;s claims management software checks CPT and ICD-10 pairs, flags missing modifiers, and catches errors before the claim leaves your practice. See how it works for orthopedic and emergency medicine teams.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Three checks decide whether a 23650 claim pays on the first pass. Confirm the record states that no anesthetic was used, attach -RT or -LT, and code the specific side and direction.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Get those right and 23650 is one of the cleanest codes in the musculoskeletal section. Miss one and the claim lands in a queue that costs more to work than the payment is worth.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The practices that stay out of that queue build the checks into the workflow rather than the coder&rsquo;s memory. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau catches missing modifiers before a shoulder claim leaves your practice.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding a humerus fracture that has not healed?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s42302k\/\">S42.302K<\/a> walks through the documentation a nonunion claim needs.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing a more complex humeral procedure?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-24410\/\">CPT code 24410<\/a> covers the reporting rules for multiple osteotomy of the humerus.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Handling spinal procedure claims as well?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-22600\/\">CPT code 22600<\/a> sets out the billing rules for posterior cervical arthrodesis.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding a subluxation rather than a full dislocation?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s33140a\/\">S33.140A<\/a> shows how partial displacement is coded and documented.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1786952133762\"><h3 class=\"schema-faq-question\">What does CPT code 23650 cover?<\/h3> <p class=\"schema-faq-answer\">CPT code 23650 covers closed treatment of a shoulder dislocation with manipulation, performed without anesthesia. The physician manually reduces the dislocated glenohumeral joint while the patient stays conscious. Techniques include external rotation, the Cunningham method, and the modified Milch maneuver. No incision or anesthetic agent is involved.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952133763\"><h3 class=\"schema-faq-question\">What is the Medicare reimbursement rate for CPT 23650 in 2026?<\/h3> <p class=\"schema-faq-answer\">The 2026 Medicare non-facility rate for CPT 23650 is approximately $434, and the facility rate is approximately $368. Both figures apply the 2026 conversion factor of $33.4009 to total RVUs of 12.99 and 11.01. Actual payment varies by locality, GPCI adjustment, and payer contract. Verify your rate with the CMS fee schedule lookup.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952133764\"><h3 class=\"schema-faq-question\">What is the difference between CPT 23650 and CPT 23655?<\/h3> <p class=\"schema-faq-answer\">CPT 23650 applies when the reduction is performed without any anesthetic agent. CPT 23655 applies when the reduction requires IV sedation, a regional nerve block, or general anesthesia. Billing 23655 when no anesthesia was given counts as upcoding and creates OIG audit exposure. The note must state whether anesthesia was used.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952133765\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT code 23650?<\/h3> <p class=\"schema-faq-answer\">The most commonly required modifiers are -RT and -LT, which record the side treated. Modifier -50 covers a bilateral procedure, though some MACs want separate line items for each side instead. Modifier -59 overrides an NCCI bundling edit when distinct services are documented. If an E\/M service happens the same day, modifier -25 goes on the E\/M code.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952133766\"><h3 class=\"schema-faq-question\">Can CPT 23650 be billed in the emergency department?<\/h3> <p class=\"schema-faq-answer\">Yes. CPT 23650 is frequently billed in the emergency department when a physician reduces a shoulder without sedation. In a hospital ED the facility rate applies, which is roughly $368 nationally for 2026. The physician bills the reduction separately from any documented E\/M service, which needs modifier -25 on the E\/M code.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952133767\"><h3 class=\"schema-faq-question\">What ICD-10 codes are used with CPT 23650?<\/h3> <p class=\"schema-faq-answer\">The most commonly paired codes are S43.014A and S43.015A for anterior dislocation of the right and left humerus. Posterior dislocations use S43.024A on the right and S43.025A on the left. S43.036A covers an inferior dislocation when the side is not specified. Reserve S43.006A for records that genuinely lack laterality.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786952133768\"><h3 class=\"schema-faq-question\">What documentation is required for CPT code 23650?<\/h3> <p class=\"schema-faq-answer\">The record needs the clinical indication and dislocation type, the reduction technique used, and an explicit statement that no anesthesia was given. It also needs pre- and post-reduction neurovascular checks, post-reduction imaging results, and the immobilization method applied. The absence-of-anesthesia statement is the element auditors find missing most often.<\/p> <\/div> <\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>The official AMA descriptor for CPT code 23650 is: Closed treatment of shoulder dislocation, with manipulation, without anesthesia. The code applies when a clinician manually reduces a dislocated glenohumeral joint without any anesthetic agent. The patient stays conscious throughout. Common reduction maneuvers include the Cunningham technique, the modified Milch, and external rotation. No incision is [&hellip;]<\/p>\n","protected":false},"author":82,"featured_media":180975,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"86","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[1163],"class_list":["post-180981","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","tag-medical-billing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT code 23650: Treatment of shoulder dislocation, no anesthesia<\/title>\n<meta name=\"description\" content=\"CPT 23650 covers closed shoulder reduction without anesthesia. Medicare pays about $434 in office and $368 in a facility in 2026.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT code 23650: Treatment of shoulder dislocation, no anesthesia\" \/>\n<meta property=\"og:description\" content=\"CPT 23650 covers closed shoulder reduction without anesthesia. Medicare pays about $434 in office and $368 in a facility in 2026.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-17T08:28:29+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-17T09:11:51+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-23650.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Maja Popovska\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"Maja Popovska\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"11 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/\"},\"author\":{\"name\":\"Maja Popovska\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/person\\\/b00aec1dd379f0ddcf6137d78e2a21db\"},\"headline\":\"CPT code 23650: Closed treatment of shoulder dislocation, without anesthesia\",\"datePublished\":\"2026-08-17T08:28:29+00:00\",\"dateModified\":\"2026-08-17T09:11:51+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/\"},\"wordCount\":2111,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-23650.webp\",\"keywords\":[\"Medical Billing\"],\"articleSection\":[\"Billing Codes\",\"CPT Codes\"],\"inLanguage\":\"fr-FR\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/\",\"name\":\"CPT code 23650: Treatment of shoulder dislocation, no anesthesia\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-23650.webp\",\"datePublished\":\"2026-08-17T08:28:29+00:00\",\"dateModified\":\"2026-08-17T09:11:51+00:00\",\"description\":\"CPT 23650 covers closed shoulder reduction without anesthesia. 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It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.\",\"foundingDate\":\"2011-10-20\",\"numberOfEmployees\":{\"@type\":\"QuantitativeValue\",\"minValue\":\"201\",\"maxValue\":\"500\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/person\\\/b00aec1dd379f0ddcf6137d78e2a21db\",\"name\":\"Maja Popovska\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-Maja-Popovska_WP-1-96x96.jpeg\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-Maja-Popovska_WP-1-96x96.jpeg\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-Maja-Popovska_WP-1-96x96.jpeg\",\"caption\":\"Maja Popovska\"},\"description\":\"Maja is a Senior Content Writer at Pabau, where she covers everything from practice management and compliance to medical aesthetics and patient experience. Off the clock: binging true crime docuseries, baking and dreaming about travel.\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/blog\\\/author\\\/maja-popovska\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133762\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133762\",\"name\":\"What does CPT code 23650 cover?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT code 23650 covers closed treatment of a shoulder dislocation with manipulation, performed without anesthesia. The physician manually reduces the dislocated glenohumeral joint while the patient stays conscious. Techniques include external rotation, the Cunningham method, and the modified Milch maneuver. No incision or anesthetic agent is involved.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133763\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133763\",\"name\":\"What is the Medicare reimbursement rate for CPT 23650 in 2026?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The 2026 Medicare non-facility rate for CPT 23650 is approximately $434, and the facility rate is approximately $368. Both figures apply the 2026 conversion factor of $33.4009 to total RVUs of 12.99 and 11.01. Actual payment varies by locality, GPCI adjustment, and payer contract. Verify your rate with the CMS fee schedule lookup.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133764\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133764\",\"name\":\"What is the difference between CPT 23650 and CPT 23655?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT 23650 applies when the reduction is performed without any anesthetic agent. CPT 23655 applies when the reduction requires IV sedation, a regional nerve block, or general anesthesia. Billing 23655 when no anesthesia was given counts as upcoding and creates OIG audit exposure. The note must state whether anesthesia was used.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133765\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133765\",\"name\":\"What modifiers apply to CPT code 23650?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The most commonly required modifiers are -RT and -LT, which record the side treated. Modifier -50 covers a bilateral procedure, though some MACs want separate line items for each side instead. Modifier -59 overrides an NCCI bundling edit when distinct services are documented. If an E\\\/M service happens the same day, modifier -25 goes on the E\\\/M code.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133766\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133766\",\"name\":\"Can CPT 23650 be billed in the emergency department?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. CPT 23650 is frequently billed in the emergency department when a physician reduces a shoulder without sedation. In a hospital ED the facility rate applies, which is roughly $368 nationally for 2026. The physician bills the reduction separately from any documented E\\\/M service, which needs modifier -25 on the E\\\/M code.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133767\",\"position\":6,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-23650\\\/#faq-question-1786952133767\",\"name\":\"What ICD-10 codes are used with CPT 23650?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The most commonly paired codes are S43.014A and S43.015A for anterior dislocation of the right and left humerus. Posterior dislocations use S43.024A on the right and S43.025A on the left. S43.036A covers an inferior dislocation when the side is not specified. 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Off the clock: binging true crime docuseries, baking and dreaming about travel.","url":"https:\/\/pabau.com\/fr\/blog\/author\/maja-popovska\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133762","position":1,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133762","name":"What does CPT code 23650 cover?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT code 23650 covers closed treatment of a shoulder dislocation with manipulation, performed without anesthesia. The physician manually reduces the dislocated glenohumeral joint while the patient stays conscious. Techniques include external rotation, the Cunningham method, and the modified Milch maneuver. No incision or anesthetic agent is involved.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133763","position":2,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133763","name":"What is the Medicare reimbursement rate for CPT 23650 in 2026?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The 2026 Medicare non-facility rate for CPT 23650 is approximately $434, and the facility rate is approximately $368. Both figures apply the 2026 conversion factor of $33.4009 to total RVUs of 12.99 and 11.01. Actual payment varies by locality, GPCI adjustment, and payer contract. Verify your rate with the CMS fee schedule lookup.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133764","position":3,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133764","name":"What is the difference between CPT 23650 and CPT 23655?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 23650 applies when the reduction is performed without any anesthetic agent. CPT 23655 applies when the reduction requires IV sedation, a regional nerve block, or general anesthesia. Billing 23655 when no anesthesia was given counts as upcoding and creates OIG audit exposure. The note must state whether anesthesia was used.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133765","position":4,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133765","name":"What modifiers apply to CPT code 23650?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The most commonly required modifiers are -RT and -LT, which record the side treated. Modifier -50 covers a bilateral procedure, though some MACs want separate line items for each side instead. Modifier -59 overrides an NCCI bundling edit when distinct services are documented. If an E\/M service happens the same day, modifier -25 goes on the E\/M code.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133766","position":5,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133766","name":"Can CPT 23650 be billed in the emergency department?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes. CPT 23650 is frequently billed in the emergency department when a physician reduces a shoulder without sedation. In a hospital ED the facility rate applies, which is roughly $368 nationally for 2026. The physician bills the reduction separately from any documented E\/M service, which needs modifier -25 on the E\/M code.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133767","position":6,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133767","name":"What ICD-10 codes are used with CPT 23650?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The most commonly paired codes are S43.014A and S43.015A for anterior dislocation of the right and left humerus. Posterior dislocations use S43.024A on the right and S43.025A on the left. S43.036A covers an inferior dislocation when the side is not specified. Reserve S43.006A for records that genuinely lack laterality.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133768","position":7,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-23650\/#faq-question-1786952133768","name":"What documentation is required for CPT code 23650?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The record needs the clinical indication and dislocation type, the reduction technique used, and an explicit statement that no anesthesia was given. It also needs pre- and post-reduction neurovascular checks, post-reduction imaging results, and the immobilization method applied. The absence-of-anesthesia statement is the element auditors find missing most often.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"}]}},"yoast":{"focus_keyword":"cpt code 23650","seo_title":"CPT code 23650: Treatment of shoulder dislocation, no anesthesia","meta_description":"CPT 23650 covers closed shoulder reduction without anesthesia. 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