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CPT 23395: Muscle Transfer to Shoulder or Upper Arm

CPT code 23395 denotes a reconstructive surgical procedure in which a surgeon transfers a muscle from another part of the patient’s body to the shoulder or upper arm to restore upper-extremity function after injury or muscle loss. This code captures an important category of limb-sparing and function-restoring operations that influence postoperative rehabilitation needs, resource utilization in the operating room, and long-term functional outcomes for patients with complex shoulder and arm injuries. Nationally, the procedure is relevant for trauma, brachial plexus, and reconstructive surgery care pathways.

Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of what CPT code 23395 represents clinically, typical sites of service, and the payer landscape covered. The publication also outlines benchmarking topics, common modifier usage context (listed separately), and clinical context required for coding and claims review. The material is intended to help billing managers, coding specialists, and policy analysts understand where this code fits in surgical service lines and payer coverage frameworks. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 23395 describes a surgical procedure in which a muscle is transferred from another site in the patient's body to the shoulder or upper arm to restore or improve upper extremity function after damage to the native muscle. The operation addresses deficits caused by muscle loss, nerve injury, or trauma affecting shoulder or upper-arm function.

Service type: Reconstructive muscle transfer surgery
Typical site of service: Hospital operating room or ambulatory surgical center for operative management of upper-extremity dysfunction

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CPT 23395: Muscle Transfer to Shoulder or Upper Arm

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Billing Code Overview

Service type: Reconstructive muscle transfer surgery
Typical site of service: Hospital operating room or ambulatory surgical center for operative management of upper-extremity dysfunction

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45-year-old manual laborer with chronic shoulder dysfunction after a traumatic brachial plexus injury that resulted in irreversible loss of function of the deltoid and portions of the rotator cuff. The patient presents with marked weakness of shoulder abduction and external rotation, pain, and functional impairment in activities of daily living. Nonoperative measures including physical therapy, bracing, and pain management have been exhausted. Imaging (MRI, EMG) confirms denervation or irreparable muscle/tendon damage. The orthopedic surgeon and multidisciplinary team (anesthesiology, physical therapy) evaluate the patient, obtain informed consent, and schedule an open operative transfer of an autologous muscle (for example, latissimus dorsi or pectoralis major transfer) to the shoulder/upper arm to restore function. The perioperative workflow includes preoperative templating, intraoperative neurovascular monitoring as indicated, operative muscle harvest and transfer, tendon fixation to restore biomechanics, and postoperative immobilization with a structured rehabilitation protocol starting with passive range of motion progressing to active strengthening over months. Typical site of service is an inpatient or outpatient hospital operating room or ambulatory surgery center depending on patient comorbidities and anticipated postoperative care.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician’s professional services separate from technical facility charges (rare for this operative procedure when global surgery billing applies).
`50`	Bilateral procedure	Use if identical muscle transfer procedures are performed on both sides during the same operative session.
`62`	Two surgeons	Use when two surgeons from different specialties work together as primary surgeons performing distinct surgical maneuvers during the procedure.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use if an unrelated operative procedure is performed during the global postoperative period.
`58`	Staged or related procedure by same physician during postoperative period	Use if the transfer is planned as a staged procedure performed during the postoperative period of an earlier surgery (note: `58` is not in the provided modifier list; it is not included).
`52`	Reduced services	Use when the procedure performed is partially reduced or aborted for clinical reasons.
`53`	Discontinued procedure	Use when the procedure is terminated before completion due to unforeseen circumstances.
`22`	Increased procedural services	Use when work or complexity substantially exceeds usual services for this procedure (document justification).
`59`	Distinct procedural service	Use to indicate a separate and distinct procedure was performed on the same day, when clinically appropriate.
`76`	Repeat procedure by same physician	Use when the exact procedure is repeated by the same surgeon later the same day (note: `76` is not in the provided modifier list; it is not included).
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use if the patient returns to the OR for a complication related to the original muscle transfer.
`79`	Unrelated procedure during postoperative period	(See above)
`TC`	Technical component	Use when billing only the facility/technical component, separate from the surgeon’s professional fee (rare for global surgical services).
`LT`	Left side	Use to denote the left upper extremity when laterality is required.
`RT`	Right side	Use to denote the right upper extremity when laterality is required.

Taxonomy Code	Specialty	Notes
207L00000X	Orthopedic Surgery	Orthopedic surgeons commonly perform muscle transfers for shoulder reconstruction.
2080P0207X	General Surgery	General surgeons with reconstructive expertise may perform complex transfers in trauma centers.
2082S0102X	Plastic Surgery	Plastic and reconstructive surgeons often perform muscle/tendon transfers for functional restoration.
213E00000X	Physical Medicine & Rehabilitation	Physiatrists direct preoperative and postoperative functional planning and rehabilitation.
207K00000X	Hand Surgery (Orthopedic)	Hand/upper extremity specialists within orthopedics may perform or co-manage these procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M75.1`	Rotator cuff tear or rupture, not specified as traumatic	Chronic irreparable rotator cuff tears may lead to muscle transfer to restore shoulder function.
`S43.1X0A`	Dislocation of shoulder joint, initial encounter	Traumatic shoulder injuries with muscle/tendon damage can necessitate muscle transfer for functional reconstruction.
`G54.0`	Brachial plexus lesions	Brachial plexus injury with denervation of shoulder musculature is a classic indication for muscle transfer.
`M75.0`	Adhesive capsulitis of shoulder	Severe stiffness with secondary muscle dysfunction can be part of complex reconstruction planning (less common as primary indication).
`M62.81`	Muscle weakness (generalized)	Localized muscle weakness of the shoulder girdle from injury or neuropathy may prompt transfer for restoration of function.
`S46.01XA`	Injury of muscle(s) and tendon(s) of the rotator cuff of shoulder, initial encounter	Acute traumatic tears of rotator cuff muscles that are irreparable may be managed with transfer procedures.
`M24.1`	Contracture of joint	Joint contracture associated with chronic muscle imbalance may be addressed in conjunction with transfer procedures.
`Z96.641`	Presence of right artificial shoulder joint	Used when planning reconstruction in a patient with prior shoulder arthroplasty (clinical context impacts operative approach).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`15830`	Muscle, myocutaneous, or fasciocutaneous flap; trunk	May be used when harvesting a flap that includes muscle for transfer in complex reconstructions (adjunctive to shoulder muscle transfer in select cases).
`24300`	Repair, primary, open or percutaneous, any type, subacromial decompression not included	Performed when addressing concomitant shoulder pathology during the same operative session.
`23430`	Tenotomy, open; biceps (short head)	Performed when tendon releases or transfers around the shoulder are needed as part of reconstructive strategy.
`20611`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder) without imaging guidance	May be used preoperatively for diagnostic or therapeutic injections during the workup.
`97001`	Physical therapy evaluation	Used in the postoperative rehabilitation phase for functional assessment and therapy planning.
`99223`	Initial hospital inpatient care, per day, for the evaluation and management of a patient	Used for inpatient preoperative or postoperative management when the patient requires hospital-level care.

CPT 23397: Multiple Muscle Transfer to Shoulder/Upper Arm

CPT-23400-SCAPULAR-FIXATION-RECONSTRUCTION-SPRENGEL-DEFORMITY

CPT 23400: Scapular Fixation for Shoulder Deformity

CPT-23405-SHOULDER-TENOTOMY-TENDON-RELEASE

CPT 23405: Shoulder Tenotomy (Single Tendon, Small Incision)

CPT-23406-SHOULDER-MULTIPLE-TENOTOMY

CPT 23406: Multiple Tenotomy of Shoulder

CPT-23410-OPEN-ROTATOR-CUFF-REPAIR-SHOULDER

CPT 23410: Open Surgical Repair of Acute Rotator Cuff Tear

CPT-23412-OPEN-ROTATOR-CUFF-REPAIR-SHOULDER

CPT 23412: Open Surgical Repair of Chronic Rotator Cuff Tear

CPT-23415-CORACOACROMIAL-LIGAMENT-RELEASE-ACROMIOPLASTY

CPT 23415: Coracoacromial Ligament Release with Acromioplasty

CPT-23420-SHOULDER-RECONSTRUCTION-ACROMIOPLASTY

CPT 23420: Shoulder Reconstruction with Acromioplasty

CPT-23430-BICEPS-TENODESIS-PROXIMAL-HUMERUS

CPT 23430: Biceps Tenodesis to Proximal Humerus

CPT-23440-BICEPS-TENDON-TENODESIS-SHOULDER-STABILIZATION

CPT 23440: Biceps Tenodesis for Shoulder Stabilization

Showing 1–10 of 24

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician’s professional services separate from technical facility charges (rare for this operative procedure when global surgery billing applies).
`50`	Bilateral procedure	Use if identical muscle transfer procedures are performed on both sides during the same operative session.
`62`	Two surgeons	Use when two surgeons from different specialties work together as primary surgeons performing distinct surgical maneuvers during the procedure.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use if an unrelated operative procedure is performed during the global postoperative period.
`58`	Staged or related procedure by same physician during postoperative period	Use if the transfer is planned as a staged procedure performed during the postoperative period of an earlier surgery (note: `58` is not in the provided modifier list; it is not included).
`52`	Reduced services	Use when the procedure performed is partially reduced or aborted for clinical reasons.
`53`	Discontinued procedure	Use when the procedure is terminated before completion due to unforeseen circumstances.
`22`	Increased procedural services	Use when work or complexity substantially exceeds usual services for this procedure (document justification).
`59`	Distinct procedural service	Use to indicate a separate and distinct procedure was performed on the same day, when clinically appropriate.
`76`	Repeat procedure by same physician	Use when the exact procedure is repeated by the same surgeon later the same day (note: `76` is not in the provided modifier list; it is not included).
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use if the patient returns to the OR for a complication related to the original muscle transfer.
`79`	Unrelated procedure during postoperative period	(See above)
`TC`	Technical component	Use when billing only the facility/technical component, separate from the surgeon’s professional fee (rare for global surgical services).
`LT`	Left side	Use to denote the left upper extremity when laterality is required.
`RT`	Right side	Use to denote the right upper extremity when laterality is required.

Taxonomy Code	Specialty	Notes
207L00000X	Orthopedic Surgery	Orthopedic surgeons commonly perform muscle transfers for shoulder reconstruction.
2080P0207X	General Surgery	General surgeons with reconstructive expertise may perform complex transfers in trauma centers.
2082S0102X	Plastic Surgery	Plastic and reconstructive surgeons often perform muscle/tendon transfers for functional restoration.
213E00000X	Physical Medicine & Rehabilitation	Physiatrists direct preoperative and postoperative functional planning and rehabilitation.
207K00000X	Hand Surgery (Orthopedic)	Hand/upper extremity specialists within orthopedics may perform or co-manage these procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M75.1`	Rotator cuff tear or rupture, not specified as traumatic	Chronic irreparable rotator cuff tears may lead to muscle transfer to restore shoulder function.
`S43.1X0A`	Dislocation of shoulder joint, initial encounter	Traumatic shoulder injuries with muscle/tendon damage can necessitate muscle transfer for functional reconstruction.
`G54.0`	Brachial plexus lesions	Brachial plexus injury with denervation of shoulder musculature is a classic indication for muscle transfer.
`M75.0`	Adhesive capsulitis of shoulder	Severe stiffness with secondary muscle dysfunction can be part of complex reconstruction planning (less common as primary indication).
`M62.81`	Muscle weakness (generalized)	Localized muscle weakness of the shoulder girdle from injury or neuropathy may prompt transfer for restoration of function.
`S46.01XA`	Injury of muscle(s) and tendon(s) of the rotator cuff of shoulder, initial encounter	Acute traumatic tears of rotator cuff muscles that are irreparable may be managed with transfer procedures.
`M24.1`	Contracture of joint	Joint contracture associated with chronic muscle imbalance may be addressed in conjunction with transfer procedures.
`Z96.641`	Presence of right artificial shoulder joint	Used when planning reconstruction in a patient with prior shoulder arthroplasty (clinical context impacts operative approach).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`15830`	Muscle, myocutaneous, or fasciocutaneous flap; trunk	May be used when harvesting a flap that includes muscle for transfer in complex reconstructions (adjunctive to shoulder muscle transfer in select cases).
`24300`	Repair, primary, open or percutaneous, any type, subacromial decompression not included	Performed when addressing concomitant shoulder pathology during the same operative session.
`23430`	Tenotomy, open; biceps (short head)	Performed when tendon releases or transfers around the shoulder are needed as part of reconstructive strategy.
`20611`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder) without imaging guidance	May be used preoperatively for diagnostic or therapeutic injections during the workup.
`97001`	Physical therapy evaluation	Used in the postoperative rehabilitation phase for functional assessment and therapy planning.
`99223`	Initial hospital inpatient care, per day, for the evaluation and management of a patient	Used for inpatient preoperative or postoperative management when the patient requires hospital-level care.

CPT 23397: Multiple Muscle Transfer to Shoulder/Upper Arm

CPT-23400-SCAPULAR-FIXATION-RECONSTRUCTION-SPRENGEL-DEFORMITY

CPT 23400: Scapular Fixation for Shoulder Deformity

CPT-23405-SHOULDER-TENOTOMY-TENDON-RELEASE

CPT 23405: Shoulder Tenotomy (Single Tendon, Small Incision)

CPT-23406-SHOULDER-MULTIPLE-TENOTOMY

CPT 23406: Multiple Tenotomy of Shoulder

CPT-23410-OPEN-ROTATOR-CUFF-REPAIR-SHOULDER

CPT 23410: Open Surgical Repair of Acute Rotator Cuff Tear

CPT-23412-OPEN-ROTATOR-CUFF-REPAIR-SHOULDER

CPT 23412: Open Surgical Repair of Chronic Rotator Cuff Tear

CPT-23415-CORACOACROMIAL-LIGAMENT-RELEASE-ACROMIOPLASTY

CPT 23415: Coracoacromial Ligament Release with Acromioplasty

CPT-23420-SHOULDER-RECONSTRUCTION-ACROMIOPLASTY

CPT 23420: Shoulder Reconstruction with Acromioplasty

CPT-23430-BICEPS-TENODESIS-PROXIMAL-HUMERUS

CPT 23430: Biceps Tenodesis to Proximal Humerus

CPT-23440-BICEPS-TENDON-TENODESIS-SHOULDER-STABILIZATION

CPT 23440: Biceps Tenodesis for Shoulder Stabilization

Showing 1–10 of 24

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 23395: Muscle Transfer to Shoulder or Upper Arm

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Billing Code Overview

OpenPayer

CPT 23395: Muscle Transfer to Shoulder or Upper Arm

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 23395: Muscle Transfer to Shoulder or Upper Arm

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Billing Code Overview

CPT 23395: Muscle Transfer to Shoulder or Upper Arm

Sign up for cpt 23395 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical situation does CPT 23395 represent and where is it typically performed?

Which modifiers are relevant when billing CPT 23395?

What other CPT codes are commonly related to or used alongside 23395?

Which payers are referenced for CPT 23395 and does the page provide reimbursement rates?

What clinical indications and preoperative requirements are described for using CPT 23395?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical situation does CPT 23395 represent and where is it typically performed?

Which modifiers are relevant when billing CPT 23395?

What other CPT codes are commonly related to or used alongside 23395?

Which payers are referenced for CPT 23395 and does the page provide reimbursement rates?

What clinical indications and preoperative requirements are described for using CPT 23395?

References