Summary & Overview
CPT 23802: Shoulder Arthrodesis with Autologous Bone Graft
CPT code 23802 represents open surgical shoulder arthrodesis: immobilization of the glenohumeral joint using fixation devices with autologous bone grafting to promote fusion. This procedure is used to restore stability and function when conservative care or prior joint replacement has failed, and it carries implications for surgical complexity, resource use, and post-operative rehabilitation recommendations nationwide. Key payers in the national scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise clinical and billing orientation to the code, including the procedure’s purpose and typical sites of service, common billing modifiers (input provided), and the broader context for coverage and utilization discussions. The publication outlines benchmarks for claim categorization and coding accuracy, summarizes clinical indications tied to shoulder arthrodesis, and highlights areas where policy language or prior authorization criteria commonly affect access and payment. Data not available in the input is noted where applicable; this summary focuses on nationally relevant clinical and billing context rather than state-specific rules or payer-specific contract terms.
Billing Code Overview
CPT code 23802 describes a surgical procedure to surgically immobilize the glenohumeral (shoulder) joint using internal fixation devices combined with an autologous bone graft to induce bone formation. The procedure is performed to restore shoulder stability and function in settings such as advanced glenohumeral arthritis or failure of prior shoulder arthroplasty.
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Service type: Open surgical shoulder arthrodesis with autologous bone grafting and internal fixation
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Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgical center, depending on clinical complexity and patient status
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with chronic, end-stage glenohumeral osteoarthritis and persistent pain and loss of shoulder function presents after conservative measures and a failed shoulder arthroplasty. The orthopedic surgeon plans an open surgical arthrodesis of the shoulder using internal fixation devices and an autologous bone graft harvested from the iliac crest to promote fusion of the glenohumeral joint. The typical clinical workflow includes preoperative evaluation (history, physical exam, imaging with radiographs and CT to assess bone stock), medical clearance, preoperative anesthesia evaluation, intraoperative open debridement of joint surfaces, placement of fixation hardware (plates, screws or intramedullary devices), insertion of autograft to augment fusion, and immediate postoperative immobilization with pain control. Postoperative care includes wound checks, radiographic follow-up to document progressive fusion, physical therapy focused on periscapular conditioning once fusion is adequate, and long-term function assessment. Typical site of service is an inpatient hospital or ambulatory surgery center depending on clinical complexity and comorbidities. Service type is an open major joint fusion with internal fixation and autograft procurement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default — no modifier appended | Not used; listed as default code set member when no other modifier applies |