Summary & Overview
CPT 23350: Shoulder Arthrography Contrast Injection
CPT code 23350 represents an image-guided injection of contrast into the shoulder joint to perform shoulder arthrography and obtain diagnostic imaging for evaluation of soft tissue injury. Nationally, this code is used in radiology and orthopedics to support diagnostic workflows for suspected labral tears, rotator cuff injuries, and other intra‑articular shoulder conditions. It matters because it directs billing for the procedural component that enables enhanced CT or MRI imaging and influences imaging utilization and payment for shoulder diagnostic pathways.
Key payers considered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose and typical service setting for the code, an outline of common modifiers and billing considerations (where available), and benchmarks and payer coverage context where applicable. The publication highlights national clinical context, how the procedure integrates with advanced imaging (CT/MRI arthrography), and the areas where policy updates and payer-specific coverage rules commonly affect use. Data not available in the input is noted where payer-specific rates, associated taxonomies, and ICD‑10 diagnosis mappings would normally be presented.
Billing Code Overview
CPT code 23350 describes an injection of contrast into the shoulder joint for shoulder arthrography, a diagnostic procedure in which a provider injects contrast into the glenohumeral joint and then obtains a series of X‑ray images. The test is used to assess the shoulder joint for soft tissue injury, such as labral or rotator cuff pathology. The procedure may be followed by computed tomography (CT) or magnetic resonance imaging (MRI) to produce enhanced CT or MRI shoulder arthrography images.
Service type: Image-guided diagnostic injection / arthrography procedure
Typical site of service: Radiology or imaging center, hospital outpatient department, or ambulatory surgery center, where fluoroscopic or ultrasound guidance and subsequent CT or MRI imaging are available.
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient presents with persistent shoulder pain and limited range of motion after a fall six weeks earlier. The orthopedic surgeon suspects a rotator cuff tear or labral injury not fully characterized by plain radiographs. After a focused history and physical exam, the provider orders an imaging study to evaluate intra-articular soft tissue structures. The patient is scheduled for a shoulder arthrography: the provider performs a fluoroscopically guided injection of iodinated contrast into the glenohumeral joint using aseptic technique. Post-injection, the patient undergoes series radiographs and may proceed to either enhanced computed tomography (CT arthrography) or magnetic resonance imaging (MR arthrography) depending on the referring clinician’s request and MRI compatibility. Typical workflow includes pre-procedure consent, verification of allergy history and renal function if CT contrast or additional contrast considerations apply, sterile preparation, local anesthesia, contrast injection under fluoroscopy, immediate image acquisition, and post-procedure observation for complications such as allergic reaction or hematoma. Typical site of service is an outpatient radiology suite or ambulatory surgery center; the service type is image-guided diagnostic injection for shoulder arthrography.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpreting physician’s professional component for imaging performed by separate technical facility. |