Summary & Overview
CPT 23670: Open Treatment of Shoulder Dislocation and Greater Tuberosity Fracture
CPT code 23670 covers open surgical treatment of shoulder dislocation, often performed when closed reduction is unsuccessful or when associated with a fracture of the greater humeral tuberosity that requires open repair. The code describes incision, open reduction of the dislocation, and optional open treatment of the greater tuberosity fracture, including use of internal fixation such as pins or screws. Nationally, this code captures higher-acuity operative management of traumatic shoulder injuries and is relevant for hospital and ambulatory surgery billing, orthopedic quality measurement, and payment policy discussions.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on procedural scope, typical settings of care, and the clinical scenarios that prompt use of this code. The publication reviews billing and coding considerations tied to open shoulder reduction and tuberosity fixation, summarizes service-level implications for hospital and ASC billing, and outlines benchmarking and policy topics affecting reimbursement and utilization for open shoulder procedures.
This summary is intended to provide clinicians, coding professionals, and policy analysts with a concise national overview of CPT code 23670, its clinical application, and areas for attention when coding and billing for open shoulder dislocation with or without greater tuberosity fixation.
Billing Code Overview
CPT code 23670 describes an open treatment of a shoulder dislocation with or without open treatment of a fracture of the greater tuberosity of the humerus. The procedure involves a surgical incision to access the shoulder joint, reduction (realignment) of the dislocated joint, and, when present, open repair of a greater humeral tuberosity fracture which may include internal fixation with pins or screws.
Service type: Operative orthopedic procedure — open shoulder stabilization and fracture fixation
Typical site of service: Hospital operating room or ambulatory surgery center, where orthopedic surgeons perform open joint reduction and internal fixation procedures.
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Clinical & Coding Specifications
Clinical Context
A 52-year-old male presents to the emergency department after a fall from standing onto his outstretched hand. He has pain, deformity, and limited range of motion of the right shoulder. Plain radiographs demonstrate an anterior glenohumeral dislocation with an associated greater tuberosity fracture of the proximal humerus. Closed reduction in the ED is attempted but the fracture fragment remains displaced and the shoulder is unstable. The orthopedic surgeon schedules the patient for an operative open reduction and internal fixation of the greater humeral tuberosity with open reduction of the shoulder dislocation under general anesthesia.
The clinical workflow includes preoperative evaluation and informed consent, preoperative imaging review (radiographs and possible CT), operating room preparation with appropriate implants (screws, suture anchors, plates if needed), open surgical approach to the shoulder, reduction of the dislocation, fixation of the greater tuberosity fracture (with or without implants), intraoperative fluoroscopy to confirm reduction and hardware position, standard wound closure, postoperative recovery and pain control, discharge planning with sling immobilization and early physiotherapy referral. Typical sites of service are ambulatory surgery centers or hospital operating rooms. The service type is operative orthopaedic procedure (open reduction and internal fixation) for traumatic shoulder dislocation with greater tuberosity fracture.
Coding Specifications
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