CPT 23472 · Other Procedure · Medicare (National NCDs)
Total Shoulder Arthroplasty (TSA / Reverse TSA) at Medicare (National NCDs).
How Medicare (National NCDs) approaches CPT 23472 (Total Shoulder Arthroplasty (TSA / Reverse TSA)) for prior-authorization review: at last review on 2025-01-01, the policy covers this code without prior authorization.
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CMS-NCD-100-03Criteria summary
High-level themes from the Medicare (National NCDs) policy of record for CPT 23472. Verbatim policy text and per-criterion analysis are available after sign-in.
- Imaging concordance documentation required.
Source: CMS National Coverage Determination Manual (Pub. 100-03) — Surgery / Orthopedics
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