Shoulder Resurfacing

This policy addresses shoulder resurfacing procedures—partial or complete humeral resurfacing, hemi‑resurfacing, and total shoulder resurfacing with or without glenoid resurfacing—for painful shoulder conditions where preservation of the humeral head is desired, including osteoarthritis, avascular necrosis, rheumatoid arthritis, cuff tear arthropathy, massive irreparable rotator cuff tears with arthritis, and select humeral head fractures. However, shoulder resurfacing is considered experimental/investigational and not covered due to limited, low‑quality evidence (no randomized trials, mostly small case series with short follow‑up), concerns about glenoid erosion and revision rates, and coverage remains subject to the member’s benefit plan.

"Treatment of painful shoulder conditions where preservation of the humeral head is desired via partial or complete humeral resurfacing."