CPT
27130 — Total hip replacement (arthroplasty)
Same scrutiny as knee replacement — verify all providers in-network.
Surgery & procedures
23472 — Arthroplasty, glenohumeral joint; total shoulder
This code covers total shoulder replacement surgery, in which both the ball (head of the humerus) and the socket (glenoid) are replaced with prosthetic components.
- Typical setting: Hospital OR, ASC
- National avg charge (illustrative): $1,500-$3,000 Medicare allowed for surgeon professional fee (total hospital charges: $25,000-$50,000+)
- Most-disputed reason: Wrong arthroplasty code: billing 23472 (total shoulder) when only a humeral head replacement (hemiarthroplasty, 23470) was performed — the prosthetic must match the code
What it means
What 23472 actually means
This code covers total shoulder replacement surgery, in which both the ball (head of the humerus) and the socket (glenoid) are replaced with prosthetic components. Total shoulder replacement is typically performed for severe shoulder arthritis, rotator cuff tear arthropathy, or fractures that destroy the joint. This is a major surgery with a 90-day global period.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Wrong arthroplasty code: billing 23472 (total shoulder) when only a humeral head replacement (hemiarthroplasty, 23470) was performed — the prosthetic must match the code
- Implant unbundling: some facilities separately bill for the prosthetic components — patients should verify whether implant costs are included in the facility fee
- Global period violations: billing routine post-surgical office visits within 90 days without modifier -24 and documentation of a new, unrelated problem
If you see 23472 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 23472 often also see these adjacent codes on the same bill.
CPT
27447 — Total knee replacement (arthroplasty)
Big-ticket surgery — verify all providers were in-network.
CPT
27486 — Revision of total knee arthroplasty, one component
Verify the code matches the actual service and dose.
CPT
29881 — Arthroscopy, knee, surgical; with meniscectomy
Verify the code matches the actual service and dose.
CPT
29888 — Arthroscopy, knee, surgical; with ACL repair/augmentation or reconstruction
Verify the code matches the actual service and dose.
Related BillBusted guides
Plain-English reads if you see 23472 on a bill.
23472 FAQ
Plain-English answers.
What does 23472 usually cost?
$1,500-$3,000 Medicare allowed for surgeon professional fee (total hospital charges: $25,000-$50,000+). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 23472?
Wrong arthroplasty code: billing 23472 (total shoulder) when only a humeral head replacement (hemiarthroplasty, 23470) was performed — the prosthetic must match the code
What should I do if I see 23472 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 23472 before paying.
Don't pay 23472 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.