Summary & Overview
CPT 23182: Excision of Infected Scapula (Osteomyelitis/Abscess)
CPT code 23182 denotes surgical excision of an infected portion of the scapula, typically performed for osteomyelitis or localized abscess of the shoulder blade. Nationally, this code captures complex musculoskeletal infection management that often requires operative debridement, coordination with infectious disease specialists, and perioperative inpatient or outpatient surgical resources. Accurate coding affects claims adjudication, quality measurement, and aggregate reporting of surgical infection care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT code 23182, benchmarks for utilization and payment where available, common billing considerations, and any relevant policy or coverage themes that affect reimbursement and preauthorization. The publication also outlines typical sites of service and procedure-level implications for claims processing and care coordination.
This summary serves clinicians, coding professionals, and policy analysts who need a quick national-level reference for CPT code 23182, explaining what the code represents, why it matters for surgical infection management, and what to expect in payer coverage and administrative handling. Data not available in the input are identified in applicable sections.
Billing Code Overview
CPT code 23182 describes a surgical procedure in which the provider excises a portion of an infected scapula (shoulder blade), commonly performed for focal osteomyelitis or abscess of the scapular bone. This procedure involves removal of infected bone and surrounding infected tissue to control local infection and preserve shoulder function.
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Service type: Surgical debridement/excision of infected bone (osseous debridement)
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Typical site of service: Hospital operating room or ambulatory surgical center with appropriate surgical and anesthesia support
Clinical & Coding Specifications
Clinical Context
A 58-year-old male presents with progressive left posterior shoulder pain, erythema, and purulent drainage over several weeks after prior hardware placement for a scapular fracture. Imaging (MRI and CT) demonstrates focal osteomyelitis of the lateral scapular spine with a localized abscess cavity involving cortical bone. The surgical team — an orthopedic surgeon with musculoskeletal infection experience — schedules operative debridement under general anesthesia. In the operating room, the provider performs an excision of the infected portion of the scapula (partial scapular resection) with drainage and debridement of the abscess, obtains intraoperative bone and fluid cultures, and irrigates the wound thoroughly. Specimens are sent to pathology and microbiology. Postoperatively the patient is transferred to the PACU and placed on IV antibiotics pending culture results, with plans for wound care and potential delayed closure or reconstructive planning depending on defect size.
Typical site of service: Hospital operating room (inpatient or outpatient depending on clinical status).
Service type: Surgical excision/debridement of infected scapular bone (partial scapulectomy) for osteomyelitis or abscess.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work, time, or effort substantially exceeds typical for due to extensive infection or reconstruction. |