2025 CPT code 23184

Partial excision of bone (craterization, saucerization, or diaphysectomy) in the proximal humerus, typically for osteomyelitis.

Adhere to CPT guidelines for bone excision procedures and those specific to osteomyelitis management.Accurate documentation is essential for appropriate coding.Consult your coding manual and payer guidelines.

Modifiers may be applied based on circumstances such as multiple procedures, bilateral procedures (50), or repeat procedures (76).

Medical necessity is established by the presence of documented osteomyelitis (confirmed via imaging and pathology), failure of conservative management (antibiotics), and the need for surgical intervention to remove infected bone and prevent further spread of infection.

The orthopedic surgeon is responsible for the pre-operative planning, performing the surgical procedure (including incision, bone excision, debridement, irrigation, drainage, and closure), post-operative care, and interpretation of the pathology report.Anesthesiologists and other medical personnel may assist.

IMPORTANT Related codes include 23180 (clavicle), 23182 (scapula), and other codes for bone debridement, incision and drainage of associated soft tissue abscesses (if present in a separate location), and bone grafting (if performed).

In simple words: The doctor removes a section of infected bone in the upper arm near the shoulder to treat an infection. This may involve creating a shallow, saucer-like area to help the infection drain. Any nearby infected tissue will also be cleaned and removed. A drain is usually placed to help remove excess fluids.

This CPT code encompasses the partial excision of bone from the proximal humerus using techniques such as craterization, saucerization, or diaphysectomy.The procedure is commonly performed to address osteomyelitis (bone infection) and involves removing the infected portion of the bone to healthy tissue, often creating a saucer-shaped depression to facilitate drainage.The excised bone is sent for pathological examination.Debridement of surrounding soft tissue, irrigation with antibiotic solution, placement of drainage tubes, and wound closure are integral parts of the procedure and are not separately reported.If a bone graft is required, it is reported separately.

Example 1: A 55-year-old male presents with chronic osteomyelitis of the proximal humerus following a previous fracture.The surgeon performs a saucerization of the infected bone to remove the necrotic tissue and facilitate drainage. Post-operative antibiotics are prescribed. , A 30-year-old female sustains a high-energy trauma resulting in an open fracture of the proximal humerus with osteomyelitis. The surgeon performs a diaphysectomy and debridement to remove the severely damaged bone and surrounding infected tissue.External fixation is applied. , A 70-year-old male presents with a chronic, localized osteomyelitic lesion in the proximal humerus.The surgeon performs a craterization to remove the infected bone, and irrigates the wound before closing. The patient is sent to physical therapy for post-operative management.

Pre-operative imaging (X-rays, CT scans, MRI), operative report detailing the extent of bone removed and techniques used, pathology report confirming the presence of osteomyelitis, post-operative orders (including antibiotics, pain management, and follow-up appointments), and any complications encountered.

** The size of the bone removed is not a factor in code selection.The specific location (proximal humerus) is the determinant for this code.If a significant amount of surrounding soft tissue requires debridement, that may be reported separately based on the extent of the debridement.

  • Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
  • RVU: This information varies depending on the payer and location.Consult the specific payer's fee schedule for RVUs and reimbursement rates.
  • Global Days : The global period for this procedure varies depending on the payer and the complexity of the surgery. Consult the specific payer's guidelines for details.
  • Payment Status: Active
  • Modifier TC rule: Technical component (TC) modifiers may be applicable based on the specific circumstances of the procedure and payer guidelines. Consult payer-specific guidelines.
  • Fee Schedule : This information varies by payer and year; consult the specific payer's historical fee schedules.
  • Specialties:Orthopedic Surgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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