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    v1.0.31
    OpenPayerBilling CodesRepair, Revision, and/or Reconstruction Procedures on the ShoulderCPT cpt-23474-shoulder-revision-arthroplasty-glenoid-humeral-revision
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    CPT 23474: Revision Arthroplasty of Shoulder, Glenoid and Humeral Components

    Medicare pays $1573 on average nationally for this procedure.

    CPT code 23474 describes a revision arthroplasty of the shoulder in which the surgeon revises both the glenoid and humeral prosthetic components, potentially using an allograft to address bone loss; this is a surgical orthopedic procedure typically performed in an inpatient or outpatient hospital surgical setting or ambulatory surgery center to remove and replace a loose or damaged shoulder prosthesis before it causes irreversible joint harm.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    Table of contents

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    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    23472Revision of total shoulder arthroplasty, humeral or glenoid component (one component)May be reported when only one component (humeral or glenoid) is revised rather than both; choose appropriate code based on components revised.
    23473Revision of total shoulder arthroplasty, humeral and glenoid components, with use of an allograftClosely related when allograft reconstruction is specifically required; choose code that best matches operative work.
    29826Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplastyMay be performed prior to or after revision arthroplasty in staged procedures or for concomitant subacromial pathology.
    20680Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)Used if additional hardware unrelated to the prosthesis is removed during the revision.
    15734Muscle, myocutaneous, or fasciocutaneous free flap with microvascular anastomosisRarely used but may be reported when complex soft-tissue reconstruction is required in revision with significant soft-tissue loss.

    Related Modifiers

    13 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…

    Showing 1–10 of 13

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207X00000X
    207L00000X
    208U00000X
    2086S0122X
    1835S0206X
    332000000X
    2085R0203X
    207SG0205X

    Related ICD-10-CM Codes

    20 rows

    ICD-10-CM CodeDescription
    M02.221Postimmunization arthropathy, right elbow
    M02.231Postimmunization arthropathy, right wrist
    M05.79Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement
    M06.09Rheumatoid arthritis without rheumatoid factor, multiple sites
    M12.111Kaschin-Beck disease, right shoulder
    M15.0Primary generalized (osteo)arthritis
    M16.11Unilateral primary osteoarthritis, right hip
    M17.11Unilateral primary osteoarthritis, right knee
    M19.011Primary osteoarthritis, right shoulder
    M19.012Primary osteoarthritis, left shoulder

    Showing 1–10 of 20

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-23395-MUSCLE-TRANSFER-SHOULDER-UPPER-ARM-RECONSTRUCTION

    CPT 23395: Muscle Transfer to Shoulder or Upper Arm

    CPT-23397-MULTIPLE-MUSCLE-TRANSFER-SHOULDER-UPPER-ARM-RECONSTRUCTION

    CPT 23397: Multiple Muscle Transfer to Shoulder or Upper Arm

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

    CPT 23400: Scapulodesis for Shoulder Asymmetry

    CPT-23405-SHOULDER-TENOTOMY-TENDON-RELEASE

    CPT 23405: Shoulder Tenotomy, Single Tendon

    CPT-23406-SHOULDER-MULTIPLE-TENOTOMY

    CPT 23406: Multiple Tenotomy of Shoulder

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

    CPT 23410: Open Repair of Acute Rotator Cuff Tear

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

    CPT 23412: Open 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: Complete Shoulder Reconstruction with Acromioplasty

    CPT-23430-BICEPS-TENODESIS-PROXIMAL-HUMERUS

    CPT 23430: Open Biceps Tenodesis, Fixation to Proximal Humerus

    Showing 1–10 of 24

    Frequently Asked Questions

    References

    1. 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. 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. 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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