Surgical removal of a single shoulder prosthesis component — either the humeral or glenoid side — including debridement and synovectomy when performed.

Verified May 8, 2026 · 5 sources ↓

Medicare: $975.97
Total RVUs: 29.22
Global, days: 90
Region: Shoulder

Drawn from CMSMdclarityAAPC

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Specify which component was removed: humeral or glenoid (single component justifies 23334 vs. 23335 for both)
State the clinical indication: infection, mechanical failure, instability, periprosthetic fracture, or other cause requiring removal
Document whether debridement and/or synovectomy were performed — these are included in 23334 and must not be billed separately
Note laterality explicitly (left or right shoulder) to support LT or RT modifier
Confirm that no replacement prosthesis was implanted in the same session — if revision arthroplasty was performed, 23334 is bundled into 23470 or 23472
If performed during a global period of a prior procedure, document the relationship (related or unrelated) to support modifier 78 or 79

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 52 Reduced services 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 23334 covers removal of one shoulder prosthesis component (humeral or glenoid) as a standalone procedure. Debridement and synovectomy performed at the same time are bundled into this code — do not bill them separately. When both components require removal, report 23335 instead.

The 90-day global period means all routine post-op care, dressing changes, and follow-up visits through day 90 are included in the payment. If the removal is performed as an unplanned return to the OR during the global period of a prior related procedure, append modifier 78. If it falls within the global of an unrelated procedure, use modifier 79.

Critical NCCI rule: 23334 cannot be reported alongside 23470 (hemiarthroplasty) or 23472 (total shoulder arthroplasty) on the ipsilateral side. When a failed prosthesis is removed and replaced in the same operative session, the arthroplasty code already captures the removal — billing 23334 separately will be denied as a bundling violation. Additionally, NCCI edits generally prohibit bypassing ipsilateral shoulder procedure pairs with modifiers; the bilateral modifier 50 only applies when procedures are performed on contralateral shoulders.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	15.11
Practice expense RVU	11.05
Malpractice RVU	3.06
Total RVU	29.22
Medicare national rate	$975.97
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$975.97
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI G2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 23334 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Bundling denial when billed same-day with 23470 or 23472 on the ipsilateral shoulder — NCCI prohibits separate billing when removal accompanies reimplantation
Missing or ambiguous laterality: payers require LT or RT on shoulder codes; absence triggers rejection or delay
Incorrect code selection: billing 23334 when both humeral and glenoid components were removed — that scenario requires 23335
Modifier 78 or 79 missing when procedure falls within the 90-day global of a prior surgery, resulting in automatic global-period denial
Debridement or synovectomy billed separately with 23334 — both are included in the code and will be denied as unbundling

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What is the difference between 23334 and 23335?

23334 is for removal of a single component — humeral or glenoid. 23335 covers removal of both components (total shoulder). If the operative report documents explantation of both, 23334 undercodes the procedure; use 23335.

02Can I bill 23334 when the surgeon removes a failed prosthesis and places a new one in the same session?

No. When removal of a failed prosthesis is followed by reimplantation in the same operative session, the revision arthroplasty codes 23470 or 23472 already include the removal. Billing 23334 separately violates NCCI and will be denied.

03Should debridement or synovectomy be billed separately when performed with 23334?

No. Debridement and synovectomy are bundled into 23334 when performed at the same operative session. Billing them separately constitutes unbundling and will be denied.

04Which modifier applies if this removal happens during the global period of a prior shoulder surgery?

Use modifier 78 if the return to the OR is for a complication or issue related to the prior procedure. Use modifier 79 if the removal is entirely unrelated to the prior surgery. Do not invert these — modifier 78 is specifically for related unplanned returns.

05Is laterality required for 23334?

Yes. Append LT or RT on every claim. Most payers — including Medicare — require laterality modifiers on unilateral shoulder procedures. Claims without them are commonly rejected or pended for additional information.

06What is the global period for 23334, and what does it include?

23334 carries a 90-day global period. That covers the surgery date, the day-before preoperative visit, and all routine post-op care through day 90. Any service unrelated to the removal billed within that window needs modifier 24 (E/M) or 79 (surgery).

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the specific component removed (humeral vs. glenoid), the clinical indication, whether debridement or synovectomy was performed, and the operative laterality — all from dictation. This prevents the two most common 23334 denials: wrong-code selection between 23334 and 23335, and missing laterality modifiers that stall claims before adjudication.

See how Mira captures CPT 23334 documentation