CPT® Code 23420

The procedure described by CPT® Code 23420 involves the reconstruction of a complete shoulder (rotator) cuff avulsion that is chronic in nature, which includes an acromioplasty. The rotator cuff is a critical structure in the shoulder, composed of a group of muscles and tendons that facilitate the motion of the shoulder joint. This group includes the supraspinatus, infraspinatus, subscapularis, and teres minor, which work together to stabilize and move the shoulder. In cases of chronic avulsion, the rotator cuff tendons may become detached from their attachment on the humeral head, leading to pain and functional impairment. During the procedure, a surgical incision is made over the shoulder joint to access the affected area. The soft tissue surrounding the joint is carefully dissected to expose the joint capsule, which is then incised to allow for inspection of the joint structures. An acromioplasty is performed to alleviate any impingement by flattening and smoothing the underside of the acromion using specialized instruments. The surgeon evaluates the rotator cuff for tears, removing any thin or fragmented portions of the tendon. The reconstruction process involves suturing the torn tendon back together, and in cases of larger defects, additional techniques such as tendon mobilization or the advancement of tendon flaps may be employed. If necessary, the site for reattachment to the bone is prepared, and metallic anchors are used to secure the tendon to the humerus, ensuring proper alignment and stability. The procedure concludes with the flushing of the joint, closure of the incisions, and application of a dressing to promote healing.