Does 23929 require prior authorization?

No, 23929 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 23929?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Pre-operative validated clinical shoulder score(s)
Pre-operative radiographs and CT imaging
Post-operative/last-follow-up validated clinical scores, radiographs, and CT for outcome assessment
Review and document the member's benefit contract or Summary Plan Description (SPD) to confirm coverage, exclusions, and any dollar or duration limits.

Treatment of painful shoulder conditions where preservation of the humeral head is desired via partial or complete humeral resurfacing.
Humeral resurfacing performed with or without concurrent resurfacing of the glenoid (resurfacing of both the humerus and glenoid).
Humeral head resurfacing (partial or complete) may be performed alone as hemi-resurfacing.
Total shoulder resurfacing (TSR) may be performed with glenoid resurfacing using implants and procedures similar to total shoulder arthroplasty.
Preserve the individual patient's normal humeral head‑neck anatomy and bone stock.
Implant a resurfacing prosthesis using a short impact‑fit peg through the humeral head/neck as an alternative to stemmed hemi- or total shoulder arthroplasty.

BCBSIL-SUR705.032 — Shoulder Resurfacing

BCBSMT-SUR705.032 — Shoulder Resurfacing

BCBSNM-SUR705.032 — Shoulder Resurfacing

BCBSOK-SUR705.032 — Shoulder Resurfacing

REGENCE-SUR226 — Subacromial Balloon Placement

Ask Verity about documentation requirements, denial risks, or coverage in your state.