CPT® Code 23335

Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder)

The procedure described by CPT® Code 23335 involves the surgical removal of a total shoulder prosthesis, which includes both the humeral and glenoid components. This procedure is typically indicated when there are complications related to the prosthesis, such as infection, mechanical failure, or other issues that necessitate its removal. The operation begins with a skin incision made over the shoulder joint, allowing access to the underlying structures. Surgeons carefully dissect through the soft tissues to expose the joint capsule, which is then opened to facilitate the removal of the prosthetic components. During the procedure, the humeral head or the entire prosthesis is dislocated to allow for a thorough inspection of the shoulder joint structures. If a hemiprosthesis was previously placed, as indicated by CPT® Code 23334, the removal process involves carefully detaching the component from either the humerus or the glenoid cavity, along with the removal of any bone cement securing the prosthesis. After the components are removed, the bony surfaces are smoothed to prepare for potential future interventions. In cases where a new prosthesis is to be placed, this would be reported as a separate procedure. Alternatively, if the removal is due to an infection, a drain may be inserted, and the soft tissues are closed around it to facilitate healing and prevent further complications.