Summary & Overview
CPT 23406: Multiple Tenotomy of Shoulder
CPT code 23406 identifies a surgical multiple tenotomy procedure of the shoulder, used to incise or divide multiple tendons through a single skin incision to correct painful congenital or acquired shoulder conditions. This code is relevant to orthopedic and hand/shoulder surgeons, surgical facilities, and payers concerned with procedural classification and billing for operative shoulder care. Nationally, accurate coding of tendon-release procedures impacts claims processing, clinical coding consistency, and aggregated utilization reporting for shoulder surgical interventions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, the typical service setting (operating room or ambulatory surgical center for outpatient or inpatient surgery), and the common modifiers used with this code. The publication outlines where CPT code 23406 fits within surgical service lines, summarizes typical billing considerations, and highlights areas where payers and providers commonly focus—such as correct procedural description and site of service documentation.
This summary equips coding and revenue staff, clinicians, and policy analysts with a clear understanding of the code’s clinical intent, expected service environment, and the payer landscape relevant to national billing and administrative workflows.
Billing Code Overview
CPT code 23406 describes a multiple tenotomy of the shoulder, a surgical procedure in which the provider incises or divides multiple tendons through a single skin incision to address painful shoulder conditions caused by congenital or acquired abnormalities. The procedure is performed to correct tendon-related sources of pain and dysfunction in the shoulder joint.
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Service type: Surgical tendon release/tenotomy of the shoulder
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Typical site of service: Operating room or ambulatory surgical center during an outpatient or inpatient surgical encounter
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents with chronic, activity-limiting shoulder pain and restricted range of motion after failed conservative management including physical therapy, corticosteroid injections, and oral analgesics. Diagnostic evaluation including physical exam and imaging (MRI) demonstrates tendinous contractures and multiple tendon involvement around the shoulder girdle causing impingement and pain. The orthopedic surgeon schedules a surgical procedure to perform a multiple tenotomy through a single skin incision to release or divide the involved tendons and relieve pain and improve function. The typical workflow includes preoperative evaluation and informed consent, regional or general anesthesia in the operating room, sterile preparation of the shoulder, a single skin incision with identification and sequential incision/division of multiple tendons (for example, subscapularis and long head of biceps or portions of rotator cuff tendons depending on pathology), hemostasis, closure, and postoperative recovery with a brief stay in the PACU and arrangement for follow-up and rehabilitation. The procedure is commonly performed in an ambulatory surgery center or hospital outpatient department; inpatient admission is uncommon unless there are significant comorbidities or concurrent procedures requiring admission.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no special circumstances apply and no other modifier is appropriate |