23040 Shoulder arthrotomy Medicare reimbursement rates in Oregon

This code describes open entry into the glenohumeral joint to inspect the joint, drain it, or remove a foreign body. An orthopedic surgeon may perform it in a hospital or other surgical facility when the treatment requires open access to the shoulder joint, such as for an intra-articular problem that cannot be managed with needle aspiration or a less invasive approach. It is distinct from procedures directed at the acromioclavicular joint, shoulder bursa, or surrounding soft tissues.

Select the code when the operative report supports open joint entry and identifies the purpose, such as exploration, drainage, or foreign-body removal. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral treatment, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.