Find policies, billing codes, payers, states, and providers
CPT 23035: Incision of Shoulder Bone Cortex for Infection
CPT code 23035 denotes surgical incision of the cortical bone in the shoulder to treat a focal bone infection, such as an abscess or osteomyelitis. Nationally, this code represents a targeted orthopedic surgical intervention used when infection involves the bone cortex and requires direct drainage or debridement. It is relevant for hospital and ambulatory surgical settings and affects surgical billing, utilization monitoring, and quality tracking for orthopedic infection management.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when the procedure is performed, typical sites of service, and payer coverage considerations. The publication outlines common billing modifiers and code relationships where available, offers benchmarking context and utilization patterns, and highlights policy or documentation elements that commonly affect claim adjudication.
This summary provides a concise reference for coding and administrative staff, clinical leads, and policy analysts seeking an overview of CPT code 23035, its clinical application, and the payer landscape. Data not available in the input will be noted where applicable in detailed sections.
Customize your policy alerts
Sign up for cpt 23035 policy alerts
Get alerted when payer policies referencing 23035 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 23035 describes a surgical procedure in which the provider incises the outer shell (cortex) of a bone in the shoulder to treat a localized pocket of infection, such as an abscess or osteomyelitis. This procedure involves accessing the cortical bone to drain or debride infected material.
-
Service type: Surgical incision and drainage of infected bone (orthopedic procedure)
-
Typical site of service: Hospital operating room or outpatient surgical center, typically within orthopedic or surgical service lines