Summary & Overview
CPT 23335: Removal of Shoulder Prosthesis, Humeral and Glenoid
CPT code 23335 denotes surgical removal of a shoulder prosthesis that involves both the humeral and glenoid components. This code captures a distinct, higher-complexity explantation procedure relative to single-component prosthesis removals and is important for accurately reflecting service intensity, operative resource use, and downstream care needs. Nationally, consistent use of this code supports appropriate claims processing and helps track surgical volume for complex shoulder revisions.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks for utilization and reimbursement patterns across major payers, guidance on common billing modifiers and coding considerations, and clinical context about when a combined humeral-and-glenoid explantation is reported. The publication summarizes payer coverage themes, typical sites of service, and expected documentation elements necessary to support the procedure code. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 23335 describes removal of a shoulder prosthesis that involves both the humeral and glenoid components. This procedure is a surgical prosthesis removal of the shoulder joint when both major implant surfaces are explanted.
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Service type: Surgical explantation of shoulder prosthesis involving both humeral and glenoid components
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old with a prior total shoulder arthroplasty who presents with progressive pain, loosening, recurrent infection, or instability of the prosthetic shoulder. Imaging (plain radiographs, CT) demonstrates humeral and glenoid component loosening and surrounding osteolysis. The orthopaedic surgeon schedules a procedure to remove both humeral and glenoid prosthetic components (CPT 23335). Preoperative workflow includes orthopedic evaluation, infection workup (CBC, ESR, CRP, aspiration if infection suspected), medication reconciliation, and anesthesia assessment. Intraoperative workflow includes removal of both humeral and glenoid components, debridement of periprosthetic tissue, possible culture sampling, and placement of an antibiotic spacer if indicated. Postoperative care includes pain control, wound care, possible inpatient observation for infection or medical comorbidity management, and planning for revision arthroplasty or staged reimplantation as appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Default when no modifier applies |
11 |