Summary & Overview
CPT 23462: Shoulder Capsulorrhaphy with Coracoid Transfer
CPT code 23462 represents an open shoulder stabilization surgery—capsulorrhaphy with coracoid transfer—performed to treat severe shoulder instability and pathologic hyperlaxity. This operative procedure is clinically meaningful because it addresses recurrent dislocation and functional impairment, with implications for surgical utilization, post-operative care, and payer coverage policy nationally. Key payers in the landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, an overview of typical sites of service, and benchmarks relevant to utilization and coverage. The publication outlines common billing considerations, frequently used modifiers, and potential documentation elements payers review. It also summarizes typical clinical indications and care pathways tied to the code, helping coding staff, clinicians, and policy analysts understand where discrepancies and coverage questions most often arise. Data not available in the input is noted where applicable, and this piece is intended as a national-level reference for coding and billing teams, compliance officers, and payers evaluating surgical shoulder stabilization claims.
Billing Code Overview
CPT code 23462 describes a surgical procedure that repairs and tightens the shoulder joint capsule (capsulorrhaphy) and includes transfer of the coracoid process of the scapula. The operation is performed to correct significant shoulder instability and hyperlaxity by reinforcing and stabilizing the glenohumeral joint.
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Service type: Open shoulder stabilization surgery with capsulorrhaphy and coracoid transfer
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Typical site of service: Hospital outpatient department or inpatient hospital surgical setting, depending on clinical severity and perioperative needs
Clinical & Coding Specifications
Clinical Context
A 28-year-old male construction worker presents with recurrent anterior shoulder dislocations after a traumatic fall six months prior. He reports episodes of instability, pain with overhead activity, and diminished work capacity despite conservative management including physical therapy and activity modification. Imaging demonstrates a Bankart lesion with capsular laxity and a bony defect of the coracoid process region consistent with recurrent instability. The orthopedic surgeon schedules an open capsulorrhaphy with transfer of the coracoid (Latarjet-type procedure) to repair the torn capsule, tighten the anterior-inferior capsule for hyperlaxity, and transfer the coracoid to augment the osseous stability of the glenoid.
Preoperative workflow includes history and physical, informed consent, pre-op imaging review (MRI/CT), anesthesia evaluation, and documentation of the indication (recurrent anterior shoulder instability). Intraoperative documentation must record the capsular repair technique, transfer and fixation method of the coracoid process, any concomitant procedures (e.g., subscapularis split), laterality, estimated blood loss, and implants used. Postoperative workflow includes recovery monitoring, discharge instructions, and follow-up for range-of-motion progression and work restriction clearance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure is performed on the left shoulder |