Summary & Overview
CPT 23474: Revision Arthroplasty of Shoulder, Glenoid and Humeral Components
CPT code 23474 represents a revision arthroplasty of the shoulder involving revision of both the glenoid and humeral components, and may include use of an allograft. This procedure addresses loose or damaged prosthetic components to prevent irreversible joint damage and is clinically significant given rising volumes of shoulder arthroplasty and the need for durable revision strategies. Nationally, CPT 23474 is relevant to hospitals and ambulatory surgical centers that provide specialty orthopedic reconstruction and to payers managing post-arthroplasty care and complications.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical intent and typical service setting, benchmarks for utilization where available, common modifier practice, and the clinical context that typically drives use of this code, including indications for prosthesis failure and grafting for bone loss. The summary highlights areas of payer focus such as medical necessity documentation and site-of-service considerations. Data not available in the input is noted as such in relevant sections. The content is organized for clinicians, coding professionals, and policy analysts seeking a clear, national-level reference for CPT code 23474.
Billing Code Overview
CPT code 23474 describes a revision arthroplasty of the shoulder in which the surgeon revises both the glenoid and humeral prosthetic components. The procedure may include the use of an allograft to reconstruct bone loss and restore joint stability. This operation is performed to remove and replace a loose or damaged shoulder prosthesis before it causes irreversible joint harm.
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Service type: Surgical revision of total shoulder arthroplasty
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Typical site of service: Hospital inpatient or outpatient surgical facility (operating room)
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with a prior total shoulder arthroplasty presents with progressive shoulder pain, decreased range of motion, and radiographic evidence of loosening of both the glenoid and humeral components. The patient reports activity-limiting pain and recurrent instability over months. Conservative care including analgesics, physical therapy, and corticosteroid injection provided only transient relief. Preoperative workup includes plain radiographs, CT for bone loss assessment, routine labs, and anesthesia clearance. In the operating room under general anesthesia (often with regional block for postoperative analgesia), the orthopedic surgeon performs a revision arthroplasty of the shoulder to remove the failed prosthetic components, prepare bone beds, address bone loss (which may include use of an allograft), and implant revised glenoid and humeral components. Typical perioperative workflow includes implant removal, debridement, possible bone grafting, trialing components, definitive implantation, irrigation, and layered closure. Postoperative care includes pain control, immobilization in a sling, early passive range-of-motion per protocol, infection surveillance, and outpatient physical therapy for progressive rehabilitation. Typical site of service is an inpatient hospital or ambulatory surgery center depending on patient comorbidities and anticipated complexity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Used when two surgeons work together as primary surgeons on complex revision requiring dual surgeon participation. |