Shoulder and Elbow CPT and ICD-10 Codes

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What are ICD-10 codes?

This internationally recognized classification of diseases is copyrighted and updated by the World Health Organization. It stands for International Statistical Classification of Diseases and Related Health Problems, (ICD-10, the number 10 represents the latest revision or version). These alphanumeric codes are used by the smallest, most rural doctor to every specialized doctors’ practice in the country, the biggest health insurance companies and international health boards in order to represent medical diagnoses. They are used by Health insurance companies when processing claims and the same codes are also used in worldwide statistics, for example, when tracking diseases, mortality or major health epidemics. It is an international language for people working in the health sector where information can be extracted and understood on an international level. The National Center for Health Statistics is the body responsible for ICD-10 review in the United States.

ICD-10 Codes Shoulder       CPT Codes        ICD-10 Codes Elbow           ICD-10 Codes Fracture

ICD-10 Codes Shoulder

 LeftRightCode is unclear to lateralityAdd-on Code
Complete Rotator Cuff TearM75.122M75.121
Partial Rotator Cuff TearM75.112M75.111
Calcific tendonitis of the shoulderM75.32M75.31
Adhesive Capsulitis (Frozen Shoulder)M75.02M75.01
Impingement Syndrome (Rotator Cuff Syndrome)M75.102M75.101
Acromioclavicular (AC) Joint Pain/ArthritisM19.012M19.011
Rotator Cuff SprainS43.422AS43.421A
Loose body in ShoulderM24.012M24.011
Acromioclavicular (AC) Joint Separation (any grade)S43.102AS43.101A
Labral Tear of the shoulderS43.432AS43.431A
Shoulder instabilityM25.312M25.311
Recurrent shoulder dislocationM24.412M24.411
Anterior shoulder dislocationS43.015AS43.014A
Posterior shoulder dislocationS43.035AS43.034A
Inferior Shoulder dislocationS43.005AS43.004A
HAGL - Humeral avulsion of inferior glenohumeral ligamentsS43.492AS43.491A
Bankart LesionS43.492AS43.491A
Hill-Sachs deformity/fractureS42.292AS42.291A
Pectoralis Major RuptureS29.011A
Biceps TenosynovitisM75.22M75.21
Rupture of long head of bicepsS46.112AS46.111A
Rotator Cuff ArthropathyM12.812M12.811
Primary Osteoarthritis of the shoulderM19.012M19.011
Post-Traumatic OA of the shoulderM19.112M19.111
Rheumatoid Arthritis of the shoulderM06.012M06.011
Avascular Necrosis of the Humeral HeadM87.012M87.011
Staphylococcal septic arthritis of the shoulderM00.012M00.011
Streptococcal septic arthritis of the shoulderM00.212M00.211
Pneumococcal septic arthritis of the shoulderM00.112M00.111
Other bacteria, septic arthritis of the shoulderM00.812M00.811
Unspecified bacteria, septic arthritis of the shoulderM00.9
Acute Gout ShoulderM10.012M10.011
Infected Shoulder ProsthesisT84.59XAZ96.619
Dislocated Shoulder ProsthesisT84.028AZ96.619
Broken Shoulder ProsthesisT84.018AZ96.619
Loosening of shoulder replacementT84.038AZ96.619
Winged ScapulaM21.80
Suprascapular Nerve EntrapmentG56.82G56.81
Thoracic Outlet SyndromeG54.0




Shoulder and Elbow CPT Codes

DescriptionCPT Code
Arthroscopic rotator cuff repair29827
Arthroscopic subacromial decompression29826
Arthroscopic biceps tenodesis29828
Arthroscopic distal clavicle excision29824
Arthroscopic extensive debridement29823
Arthroscopic limited debridement29822
Arthroscopic complete synovial debridement29821
Arthroscopic partial synovial debridement29820
Arthroscopic Loose body removal29819
Arthroscopic labral repair or capsulorrhaphy29806
Arthroscopic SLAP Repair29807
Arthroscopic Hill-Sachs Remplissage29827
Arthroscopic Latarjet29999, open equivalent 23462
Arthroscopic posterior bone block29999, open equivalent 23465
Arthroscopic supra scapular nerve release29999
Total shoulder/reverse shoulder arthroplasty23472
Modified l'episcopo 23397
Revision shoulder arthroplasty one component w/allograft23473
Revision shoulder arthroplasty both components w/allograft23474
Shoulder hemiarthroplasty23470
Bone graft20900
Pectoralis major repair24341
Pectoralis major transfer23395
Open long head biceps tenodesis24340
MUA shoulder23700
Shoulder fusion23800
Hardware removal20680
AC reconstruction without graft23550
AC reconstruction with graft23552
Open distal clavicle excision23120
Clavicle ORIF23515
ORIF Proximal humerus23615
Proximal humerus hemiarthroplasty for fracture23616
ORIF Greater tuberosity23630
Open shoulder reduction with ORIF GT23670
Open shoulder reduction with proximal humerus ORIF23680
ORIF humerus with plates24515
IM nailing of humerus24516
ORIF Scapula - glenoid, scapular body fracture, acromion 23585
DescriptionCPT Code
Arthroscopy elbow diagnostic29830
Arthroscopy elbow loose body removal29834
Arthroscopy elbow partial synovectomy29835
Arthroscopy elbow complete synovectomy29836
Arthroscopy elbow limited debridement29837
Arthroscopy elbow extensive debridement29838
Distal Triceps Reconstruction (insertion)24342
Distal Biceps Reconstruction (insertion)24342
Medial or Lateral epicondyle debridement24358
Medial or Lateral epicondyle debridement with reattachment24359
Olecranon bursectomy24105
Reconstruction of LCL elbow with graft24344
Repair of LCL elbow with local tissue24343
Reconstruction of MCL elbow with graft24346
Repair of MCL elbow with local tissue24345
Excision bone spur olecranon24120
Open Extensive debridement of the elbow24006
Open release of elbow with bone24149
Radial Head Arthroplasty24366
Total Elbow Arthroplasty24363
Revision Total Elbow Arthroplasty; One Component24370
Revision Total Elbow Arthroplasty; Both Components24371
Interposition Elbow Arthroplasty24360
MUA of Elbow23700
Radial Head Excision24130
Elbow arthrodesis24800
Implant Removal24160
Radial head implant removal24164
Olecranon Fracture ORIF24685
Coronoid Fracture ORIF24685
ORIF Distal humerus fracture without intercondylar extension24545
ORIF Distal humerus fracture with intercondylar extension24546
ORIF Medial or Lateral humeral condyle24579
ORIF Medial or lateral epicondyle of the distal humerus24575
Open treatment of Elbow Fracture Dislocation24586
Open treatment of Elbow Fracture Dislocation with arthroplasty24587
Open treatment of Acute or Chronic Elbow Dislocation24615
ORIF of Monteggia Elbow Fracture24635
ORIF of Radial head or neck fracture24665
Ulnar Nerve Transposition64718




ICD-10 Codes Elbow

 LeftRightCode is unclear to lateralityAdd-on Code
Anterior elbow dislocationS53.115AS53.114A
Posterior elbow dislocationS53.125AS53.124A
Medial elbow dislocationS53.135AS53.134A
Lateral elbow dislocationS53.145AS53.144A
Ulnar collateral ligament of the elbow tear or sprainS53.422AS53.421A
Radial collateral ligament of the elbow tear or sprainS53.432AS53.431A
Elbow InstabilityM25.322M25.321
Lateral epicondylitis (tennis elbow)M77.12M77.11
Medial epicondylitis (golferÕs elbow)M77.02M77.01
Olecranon bursitisM70.22M70.21
Septic olecranon bursitisM71.122M71.121B96.89
Loose body elbowM24.022M24.021
Primary Osteoarthritis of the elbowM19.022M19.021
Post Traumatic OA of the elbowM19.122M19.121
Rheumatoid Arthritis of the elbowM05.722M05.721
Infected Elbow ProsthesisT84.59XAZ96.619
Dislocated Elbow ProsthesisT84.028AZ96.619
Broken Elbow ProsthesisT84.018AZ96.619
Staphylococcal septic arthritis of the elbowM00.022M00.021
Streptococcal septic arthritis of the elbowM00.222M00.221
Pneumococcal septic arthritis of the elbowM00.122M00.121
Other bacteria, septic arthritis of the elbowM00.822M00.821
Unspecified bacteria, septic arthritis of the elbowM00.9
Acute Gout ElbowM10.022M10.021
Distal biceps ruptureS46.212AS46.211A
Distal triceps ruptureS46.312AS46.311A




Shoulder and Elbow Fracture ICD-10 Codes

Fracture LocationLeft DisplacedRight DisplacedLeft NondisplacedRight Nondisplaced
Sternal end of clavicle fracture, Anterior displacementS42.012AS42.011AS42.018AS42.017A
Sternal end of clavicle fracture, posterior displacementS42.015AS42.014AS42.018AS42.017A
Clavicle shaft fractureS42.022AS42.021AS42.025AS42.024A
Lateral end of clavicle fractureS42.032AS42.031AS42.035AS42.034A
Coracoid Process FractureS42.132AS42.131AS42.135AS42.134A
Scapular Body FractureS42.112AS42.111AS42.115AS42.114A
Acromial Process FractureS42.122AS42.121AS42.125AS42.124A
Glenoid Cavity FractureS42.142AS42.141AS42.145AS42.144A
2-part proximal humerus surgical neck fractureS42.222AS42.221AS42.225AS42.224A
3-part proximal humerus surgical neck fractureS42.232AS42.231AS42.235AS42.234A
4-part proximal humerus surgical neck fractureS42.242AS42.241AS42.245AS42.244A
Greater tuberosity fractureS42.252AS42.251AS42.255AS42.254A
Lesser tuberosity fractureS42.262AS42.261AS42.265AS42.264A
Transverse humeral shaft fractureS42.322AS42.321AS42.325AS42.324A
Oblique humeral shaft fractureS42.332AS42.331AS42.335AS42.334A
Spiral humeral shaft fractureS42.342AS42.341AS42.345AS42.344A
Comminuted humeral shaft fractureS42.352AS42.351AS42.355AS42.354A
Segmental humeral shaft fractureS42.362AS42.361AS42.365AS42.364A
Simple supracondylar fracture without intercondylar extensionS42.412AS42.411AS42.415AS42.414A
Comminuted supracondylar fracture without intercondylar extensionS42.422AS42.421AS42.425AS42.424A
Lateral epicondyle fracture of humerusS42.432AS42.431AS42.435AS42.434A
Medial epicondyle fracture of humerusS42.442AS42.441AS42.445AS42.444A
Lateral condyle fracture of humerusS42.452AS42.451AS42.455AS42.454A
Medial condyle fracture of humerusS42.462AS42.461AS42.465AS42.464A
Transcondylar fracture of humerusS42.472AS42.471AS42.475AS42.474A
Olecranon process fracture with no intra-articular extensionS52.022AS52.021AS52.025AS52.024A
Olecranon process fracture with intra-articular extensionS52.032AS52.031AS52.035AS52.034A
Coronoid Process fractureS52.042AS52.041AS52.045AS52.044A
Radial Head fractureS52.122AS52.121AS52.125AS52.124A
Radial Neck fractureS52.132AS52.131AS52.135AS52.134A
Greenstick fracture of ulnar shaftS52.212AS52.211A
Transverse fracture of ulnar shaftS52.222AS52.221AS52.225AS52.224A
Oblique fracture of ulnar shaftS52.232AS52.231AS52.235AS52.234A
Spiral fracture of ulnar shaftS52.242AS52.241AS52.245AS52.244A
Comminuted fracture of ulnar shaftS52.252AS52.251AS52.255AS52.254A
Segmental fracture of ulnar shaftS52.262AS52.261AS52.265AS52.264A
Monteggia's fractureS52.272AS52.271A
Greenstick fracture of radial shaftS52.312AS52.311A
Transverse fracture of radial shaftS52.322AS52.321AS52.325AS52.324A
Oblique fracture of radial shaftS52.332AS52.331AS52.335AS52.334A
Spiral fracture of radial shaftS52.342AS52.341AS52.345AS52.344A
Comminuted fracture of radial shaftS52.352AS52.351AS52.355AS52.354A
Segmental fracture of radial shaftS52.362AS52.361AS52.365AS52.364A
Galeazzi's fractureS52.372AS52.371A




On Call Reference

DiagnosisICD-10 LeftICD-10 RightCPT Code DescriptionCPT Code
Intertrochanteric Hip FractureS72.142AS72.141AIM nailing27245
Subtrochanteric Hip FractureS72.22XAS72.21XAIM nailing27245
Displaced femoral neck fractureS72.032AS72.031AHip hemiarthroplasty27236
Nondisplaced femoral neck fractureS72.035AS72.034ACRPP Femoral neck27235
Patellar tendon ruptureM66.262M66.261Patellar Tendon Repair27380
Quad Tendon RuptureS76.112AS76.111AQuad Tendon Repair27385
Tibial Shaft FractureS82.232AS82.231ATibial Nailing27759
Patellar FractureS82.032AS82.031AORIF Patella27524
Compartment SyndromeT79.A22T79.A21Fasciotomies27602
Achilles RuptureS86.012AS86.011AAchilles Repair27650
Displaced lateral malleolarl fractureS82.62XAS82.61XAORIF Lat Mal27792
Displaced bimalleolar fractureS82.842AS82.841AORIF BiMal27814
Displaced trimalleolar fractureS82.852AS82.851AORIF TriMal27822
Syndesmotic InjuryS93.432AS93.431ASyndesmosis27829




Note on Trauma Codes (S ICD-10 codes): A implies initial evaluation or first time treating patient with a closed injury, B is open fracture Gustilo-Anderson Types 1/2, C is Gustilo-Anderson Type 3.




E/M Coding

99201-99205 Office New
99211-99215 Office Return
99241-99245 Office New or Return Consult
99221-99223 Inpatient Initial
99231-99233 Inpatient Subsequent
99251-99255 Inpatient Initial Consult






Understanding ICD-10 Codes

Each ICD-10 code has numbers and letters, from 3-7 characters. Every code represents a specific diagnosis with particular details.

The ICD-10 code for frozen shoulder, for example, is M75.0 (Adhesive capsulitis of unspecified shoulder). The M75 part of the code tells the user that the diagnosis refers to a shoulder lesion. The number that follows tells the user if it is the right shoulder “.01” , left shoulder “.02” or unspecified “0”.

Adhesive capsulitis of right shoulder – M75.01
Adhesive capsulitis of left shoulder – M75.02

In the case of a labral tear in the shoulder the ICD code would be S43.439 – the user would recognize this code to be a superior glenoid labrum lesion of unspecified shoulder. By changing the last digit of the code, to a 1 or 2, the code specifies the shoulder where 1 is the right shoulder and 2 indicates the left shoulder.

Within this code the body part/site is identified along with other clinical details.

How to use the ICD-10 codes

When a patient’s medical diagnosis has been coded this information can be used in various ways. The code is used in health insurance claims – this way it is identifiable to the insurance company when processing the claim.

The ICD-10 coding system is extremely beneficial in data collection and for researchers who are looking at the spread of disease or its prevalence in various geographical areas, ages, sexes. While research is important for disease control and prevention, insurers might also use the information to forecast future health care costs to countries and governments.

What are CPT Codes?

The acronym CPT stands for Current Procedural Terminology and is widely used by health care professionals, hospitals and insurance companies, just as the ICD-10 codes are. However, while ICD codes explain the diagnoses, a CPT code describes the procedures and services including medical, surgical and diagnostic, that the medical practitioner provides during a visit.

Why are CPT Codes important?

The CPT code is assigned by a coder, who communicates directly with the doctor to have clarity of the specific diagnosis so that accuracy is guaranteed. Getting the CPT code right is imperative as it is the code that will be used to reimburse or pay the patient. Getting the code wrong could mean underpayment or no payment at all.

For example, shoulder labral tears can be investigated by a surgeon using arthroscopy. This is where the surgeon inserts a small fiber-optic camera into the joint through a small incision on the skin. The surgeon can clearly see the joint and use this procedure to help confirm and treat conditions such as labral tears.

Coders must be aware of differences in the types of labral tears and the procedure involved when applying the correct code. Type 1 labral tear (debridement) has the code 29822 whereas type 3 can be a debridement or a SLAP repair therefore going under code number 29807 (Arthroscopy, shoulder, surgical repair of lesion). It is important for the coder to see the medical records and apply the appropriate code which will guarantee the correct payment to the patient.

CPT and ICD codes are necessary for the smooth payment between medical practitioners and insurance companies, giving the patient the ease of mind that their insurance will cover any medical expenses and no money needs to be paid up front.


Please note that information on this page was not authored by Dr. Daniel Grant Schwartz, but was merely painstakingly collected and organized with the characteristic OCD of a surgeon.  It has not been proofread (yet) or intended for general public use. Information is intended for internal use only and is only a compilation.