CPT 23430 · Other Procedure · Medicare (NGS MAC)
Tenodesis of Long Tendon of Biceps at Medicare (NGS MAC).
How Medicare (NGS MAC) approaches CPT 23430 (Tenodesis of Long Tendon of Biceps) for prior-authorization review: at last review on 2026-05-03, the policy covers this code without prior authorization.
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Coverage
Covered
Prior auth
No prior auth
Last reviewed
2026-05-03
Policy number
No active LCD (NGS)Criteria summary
High-level themes from the Medicare (NGS MAC) policy of record for CPT 23430. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: CMS IOM 100-08 — Reasonable and Necessary; NGS no specific LCD
See the full Medicare (NGS MAC) criteria.
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