Summary & Overview
CPT 23530: Open Repair, Sternoclavicular Dislocation with Internal Fixation
CPT code 23530 represents the open surgical repair and internal fixation of acute or chronic sternoclavicular dislocations. This procedure is used to reduce and stabilize a new or recurrent separation of the sternoclavicular joint using implants such as pins or screws. Nationally, the code captures definitive operative management for a relatively uncommon but clinically significant shoulder girdle injury that can impact respiratory function, cosmesis, and joint stability when left untreated.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and guidance on where to find related billing and coding considerations. The publication summarizes benchmarks and payment context where available, highlights common clinical indications, and outlines areas for coding attention such as operative approach and use of internal fixation. Data limitations are noted where input fields were not provided.
This overview is intended for coding professionals, surgical practices, and revenue cycle teams seeking a national-level understanding of the clinical and billing purpose of CPT code 23530 and the practical settings in which the service is delivered.
Billing Code Overview
CPT code 23530 describes an open treatment of an acute or chronic sternoclavicular dislocation using internal fixation implants (pins or screws) to reduce and stabilize a new or recurrent abnormal separation of the sternoclavicular joint.
Service type: Surgical procedure — open joint repair with internal fixation
Typical site of service: Hospital operating room or ambulatory surgery center (inpatient or outpatient surgical setting)
Clinical & Coding Specifications
Clinical Context
A 42-year-old male pedestrian struck by a motor vehicle presents to the emergency department with left shoulder pain, visible deformity at the medial clavicle, and limited range of motion. Imaging with chest and clavicle radiographs and CT confirms a displaced acute left sternoclavicular joint dislocation with instability and concern for mediastinal compression. The orthopedic surgeon evaluates the patient, documents failed closed reduction or an irreducible/unstable dislocation, and schedules open surgical treatment.
In the operating room under general anesthesia, the surgeon performs an open reduction of the sternoclavicular joint and internal fixation using pins or screws to stabilize the joint. Intraoperative fluoroscopy may be used to confirm hardware placement. Postoperatively the patient is monitored in a post-anesthesia care unit, discharged with sling immobilization, and arranged for outpatient follow-up and physical therapy once soft-tissue healing permits.
Typical site of service: Hospital inpatient or outpatient surgical center depending on injury severity and comorbidities.
Service type: Open surgical orthopaedic treatment with internal fixation of sternoclavicular dislocation, including reduction and implant fixation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |