CPT 23430 · Other Procedure · Medicare (WPS MAC)
Biceps Tenodesis (open) at Medicare (WPS MAC).
How Medicare (WPS MAC) approaches CPT 23430 (Biceps Tenodesis (open)) 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
WPS-RN-23430Criteria summary
High-level themes from the Medicare (WPS 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: Medicare (WPS) — Reasonable-and-necessary; no 23430-specific LCD
See the full Medicare (WPS MAC) criteria.
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