Summary & Overview
CPT 23675: Closed Reduction of Shoulder Dislocation with Proximal Humerus Fracture
CPT code 23675 covers closed reduction of a shoulder dislocation combined with reduction of a surgical or anatomical neck fracture of the proximal humerus, including passive manipulation of the shoulder. This procedure addresses acute traumatic injuries that may require prompt realignment to restore joint function, relieve pain, and reduce risks of neurovascular compromise. Nationally, the code is important for emergency and orthopedic service lines where timely closed management can avoid open surgery for select patients.
Key payers in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for CPT code 23675, typical sites of service where the procedure is furnished, and the payer mix commonly relevant for reimbursement and prior authorization processes. The publication outlines benchmark considerations, common billing modifiers encountered for procedural nuances, and policy topics that affect coverage and documentation expectations.
This summary equips clinicians, billing staff, and policy analysts with a clear understanding of the procedure represented by CPT code 23675, the settings in which it is delivered, and the payer landscape to consider when managing coding, claims, and compliance workflows.
Billing Code Overview
CPT code 23675 describes a closed treatment of shoulder joint dislocation with reduction of a surgical or anatomical neck fracture of the humerus and manipulation. The procedure involves realigning the dislocated shoulder joint and reducing a proximal humerus fracture through closed (non‑open) techniques, with passive manipulation of the shoulder to restore alignment and range of motion.
Service Type: Closed reduction and manipulation of shoulder dislocation with proximal humerus fracture reduction
Typical Site of Service: Emergency department, hospital outpatient department, or accredited ambulatory surgical center, depending on patient stability, need for sedation or anesthesia, and facility capabilities.
Clinical & Coding Specifications
Clinical Context
A 48-year-old male presents to the emergency department after a fall onto his outstretched hand with acute shoulder pain, visible deformity, and inability to move the arm. Initial assessment includes neurovascular exam and plain radiographs of the shoulder revealing an anterior glenohumeral dislocation with an associated surgical neck fracture of the proximal humerus. The orthopedic provider discusses closed reduction under conscious sedation with the patient, documents informed consent, and coordinates procedural sedation with emergency department anesthesia or monitored anesthesia care as indicated. The clinician performs a closed reduction of the shoulder dislocation and manipulates the fracture fragment to achieve alignment of the surgical/anatomical neck of the humerus. Post-reduction radiographs confirm concentric reduction of the joint and acceptable alignment of the fracture. The patient is placed in a sling or shoulder immobilizer, given discharge instructions, and arranged for orthopedic follow-up for possible surgical fixation if reduction is unstable or healing is inadequate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | When the procedure is performed on the right shoulder |
LT | Left side |