CPT 23472 · Other Procedure · Medicare (CGS MAC)
Total Shoulder Arthroplasty (TSA / Reverse TSA) at Medicare (CGS MAC).
How Medicare (CGS MAC) approaches CPT 23472 (Total Shoulder Arthroplasty (TSA / Reverse TSA)) for prior-authorization review: at last review on 2026-05-09, the policy covers this code without prior authorization.
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CGS-J15-OPD-PACriteria summary
High-level themes from the Medicare (CGS MAC) policy of record for CPT 23472. Verbatim policy text and per-criterion analysis are available after sign-in.
- Imaging concordance documentation required.
Source: CGS J15 — Hospital Outpatient Department Prior Authorization (PA) Process
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