CPT 23044 Acromioclavicular Debridement Reimbursement | OpenPayer

Summary & Overview

CPT 23044: Acromioclavicular or Sternoclavicular Joint Debridement

CPT code 23044 represents open surgical inspection and debridement of the acromioclavicular or sternoclavicular joint to remove loose material and restore joint function. This procedure is clinically important for patients with persistent joint pain, mechanical symptoms, or mobility loss due to intra-articular debris or degenerative changes. Nationally, the code captures a subset of shoulder and sternoclavicular surgeries performed in hospital operating rooms and outpatient surgery centers and factors into surgical utilization and payment policy discussions for upper-extremity joint procedures.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise summary of the code’s clinical intent and typical settings, benchmark considerations and utilization context, and relevant policy and billing points to inform coding accuracy and administrative workflows. The publication highlights common modifier use and payer-specific billing practices where available, and notes when input data elements were not provided. The content is intended for national audiences including coding professionals, revenue cycle teams, and policy analysts seeking a clear view of the clinical and administrative role of CPT code 23044.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 23044acromioclavicular debridementsternoclavicular jointorthopedic surgeryopen joint debridementsurgical codingshoulder surgeryoutpatient surgery

Billing Code Overview

CPT code 23044 describes an open surgical procedure in which the provider incises the acromioclavicular or sternoclavicular joint to inspect internal joint structures and remove loose material, such as cartilage fragments, to relieve pain and restore mobility. This procedure is typically classified as a surgical joint debridement or exploration.

Service type: Open surgical joint inspection and debridement
Typical site of service: Hospital operating room or outpatient surgery center

Clinical & Coding Specifications

Clinical Context

A 46-year-old patient presents with persistent shoulder pain and limited overhead activity after a history of repetitive use and recent steroid injection that provided only temporary relief. Physical exam demonstrates pain localized to the acromioclavicular joint with tenderness at the AC joint and pain with cross-body adduction. Imaging (plain radiographs ± MRI) shows degenerative changes and small joint osteophytes with intermittent loose bodies. Conservative care including activity modification, NSAIDs, physical therapy, and injections has failed. The orthopedic surgeon schedules an open incision and debridement of the acromioclavicular joint to remove loose cartilage fragments and synovial debris to relieve pain and restore motion.

The typical workflow includes preoperative evaluation and imaging review, informed consent, regional or general anesthesia, a focused incision over the AC joint, limited arthrotomy or open incision into the AC joint, inspection and removal of loose bodies and degenerated cartilage, irrigation, hemostasis, layered closure, and outpatient recovery with postoperative pain control and a short course of physical therapy for range-of-motion restoration. Usual site of service is an ambulatory surgery center or hospital outpatient surgical department. The service is billed as a surgical debridement of the acromioclavicular joint using 23044.

Coding Specifications

Modifier	Description	When to Use
`22`

CPT 23031: Incision and Drainage of Infected Shoulder Bursa

CPT-23000-SHOULDER-CALCIFIC-DEPOSIT-EXCISION

CPT 23000: Excision of Shoulder Calcific Deposits

CPT-23020-SHOULDER-CAPSULAR-RELEASE-CONTRACTURE

CPT 23020: Shoulder Capsular Release for Contracture

CPT-23030-SHOULDER-DEEP-INCISION-AND-DRAINAGE

CPT 23030: Incision and Drainage of Deep Shoulder Abscess or Hematoma

CPT-23040-SHOULDER-OPEN-JOINT-EXPLORATION-IRRIGATION-DEBRIDEMENT

CPT 23040: Open Shoulder Joint Exploration, Irrigation and Debridement

CPT-23035-SHOULDER-BONE-CORTEX-INCISION-FOR-INFECTION

CPT 23035: Incision of Shoulder Bone Cortex for Infection

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopedic Surgery	Most common specialty performing `23044`.
`207L00000X`	Sports Medicine (Orthopedic)	Often performs AC joint procedures for athletes and active adults.
`2084P0800X`	Hand Surgery (Orthopedic)	May perform when AC pathology involves distal clavicle and shoulder girdle in complex cases.
`207K00000X`	Physical Medicine & Rehabilitation	Participates in pre/postoperative nonoperative care and rehab planning.
`2086S0122X`	Pain Medicine Anesthesiology	May provide anesthesia or perioperative pain management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M75.11`	Adhesive capsulitis of right shoulder	Shoulder pain and limited motion that can coexist with AC joint pathology and may be evaluated during surgical planning.
`M75.12`	Adhesive capsulitis of left shoulder	See above for the left shoulder.
`M19.011`	Primary osteoarthritis, right shoulder	Degenerative changes affecting the AC joint may prompt debridement to remove loose bodies and inflamed tissue.
`M19.012`	Primary osteoarthritis, left shoulder	See above for left shoulder.
`M75.31`	Calcific tendinitis of right shoulder	Tendinous calcifications near the AC joint can cause pain and be addressed in the differential diagnosis.
`M75.32`	Calcific tendinitis of left shoulder	See above for left shoulder.
`S43.001A`	Unspecified dislocation of right shoulder joint, initial encounter	Traumatic events causing AC joint disruption with intra-articular fragments may require debridement.
`S43.002A`	Unspecified dislocation of left shoulder joint, initial encounter	See above for left shoulder.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29826`	Arthroscopy, shoulder, surgical; distal claviculectomy including partial excision of the distal clavicle and excision of the acromioclavicular joint	Arthroscopic alternative to open AC joint debridement or may be performed in the same operative session when arthroscopic access is used.
`23120`	Excision or partial excision, clavicle, distal end	More extensive resection of the distal clavicle; may represent a follow-up or alternative procedure for persistent AC joint osteoarthritis.
`72050`	Radiologic examination, spine, single view	Preoperative or postoperative radiographs of the cervical/thoracic region when indicated (general imaging code example).
`73030`	Radiologic examination, shoulder; complete, minimum of two views	Preoperative and postoperative imaging to assess AC joint alignment and postoperative status.
`99024`	Postoperative follow-up visit(s) following surgical procedures during the global period	Used for routine postoperative visits related to `23044` during the global surgical period.

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