Summary & Overview
CPT 23552: Open Reconstruction for Acromioclavicular Dislocation with Fascia Graft
CPT code 23552 represents an open surgical reconstruction for acute or chronic acromioclavicular dislocation using a fascia graft and internal fixation implants. This code is used to report definitive operative management of acromioclavicular joint separation when soft-tissue reconstruction and hardware fixation are required. Nationally, procedures coded with CPT code 23552 are relevant to orthopedic surgical practice patterns, device utilization, and inpatient/outpatient surgical resource planning.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context explaining the procedure and typical sites of service, guidance on common billing modifiers (listed separately), and a summary of payer coverage considerations. The publication also outlines benchmarks and policy-relevant points for coding consistency, authorization requirements, and device-related billing implications where applicable.
This summary is intended for billing managers, orthopedic surgeons, clinical coders, and policy analysts seeking a clear statement of what CPT code 23552 represents, which payers are typically involved, and what topics are covered in the full publication, including reimbursement benchmarks, clinical indications, and coding best practices. Data not available in the input is noted where applicable throughout the document.
Billing Code Overview
CPT code 23552 describes an open surgical treatment of an acute or chronic acromioclavicular dislocation using a fascia graft with internal fixation (for example, pins or screws). The procedure addresses abnormal separation of the acromioclavicular joint by reconstructing stabilizing soft tissues and securing the clavicle to the acromion or coracoid process with implants.
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Service type: Open orthopedic reconstructive surgery
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Typical site of service: Inpatient or outpatient hospital operating room; ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 42-year-old male construction worker presents after a fall onto his left shoulder with persistent pain, visible deformity at the acromioclavicular joint, and inability to lift heavy objects. Imaging (AP and Zanca view radiographs, sometimes CT) confirms a high-grade acute acromioclavicular joint separation with coracoclavicular ligament disruption. After failed conservative management or for high-grade injuries, an orthopedic surgeon performs an open reduction and internal fixation of the acromioclavicular joint using a fascia graft for reconstruction of the coracoclavicular ligaments and internal fixation with screws or pins to maintain reduction.
The clinical workflow includes preoperative evaluation (history, focused shoulder exam, neurovascular check), informed consent, surgical planning with selection of graft and fixation implants, anesthesia (general or regional), the open surgical procedure with graft harvest or use of allograft, fixation of the clavicle to the acromion/coracoid with hardware, intraoperative imaging to confirm reduction, wound closure, postoperative immobilization in a sling, and scheduled follow-up visits with radiographs and progressive rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure is performed on the left shoulder/clavicle. |