CPT 23472 · Other Procedure · Medicare (WPS MAC)
Total Shoulder Arthroplasty (TSA / Reverse TSA) at Medicare (WPS MAC).
How Medicare (WPS MAC) approaches CPT 23472 (Total Shoulder Arthroplasty (TSA / Reverse TSA)) for prior-authorization review: at last review on 2025-02-01, the policy covers this code without prior authorization.
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WPS-J5J8-OPD-PACriteria summary
High-level themes from the Medicare (WPS MAC) policy of record for CPT 23472. Verbatim policy text and per-criterion analysis are available after sign-in.
- Imaging concordance documentation required.
Source: WPS Government Health Administrators (J5/J8) — OPD Prior Authorization
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