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Billing a shoulder dislocation reduced under procedural sedation

The scenario

35M presents with a large anterior shoulder dislocation. You sedate with propofol (12 min total sedation time) and reduce successfully. Day shift.

How to bill it

Level 2 (01812) at 50% = $46.74 + shoulder reduction with-GA (52722) $255.56 = $302.30. Cannot bill sedation codes alongside with-GA code; sedation is bundled into 52722.

What to watch for

Think about the with-GA code and whether you can also bill sedation separately.

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