CPT® Code 23935

The procedure described by CPT® Code 23935 involves a deep incision that opens the bone cortex, specifically targeting areas such as the humeral shaft, distal humerus, radial head or neck, or the olecranon process. This surgical intervention is primarily performed to address conditions like osteomyelitis, which is an infection of the bone, or a bone abscess, which is a localized collection of pus within the bone. The process begins with making an incision in the skin, which is then extended through the soft tissue that covers the infected bone area. Following this, the periosteum, which is the dense layer of vascular connective tissue enveloping the bones, is carefully elevated to access the underlying bone. A small section, referred to as a button of cortical bone, is removed to expose the bone marrow. This exposure is crucial as it alleviates the pressure that may have built up due to inflammation within the bone marrow, thereby preventing any further restriction of blood flow to the infected area. In cases where pus is present, the initial opening may be enlarged using surgical instruments such as a chisel or gouge, allowing for better drainage and access along the bone for a distance of one to two inches. If the infection has spread to the epiphysis, which is the end part of a long bone, a portion of the epiphyseal cortex may also be excised to ensure complete drainage of the abscess. This procedure is essential for treating severe bone infections and facilitating recovery by removing infected tissue and allowing for proper healing of the bone.