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Official Description

Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Arthrodesis of the shoulder, specifically the glenohumeral joint, is a surgical procedure aimed at fusing the joint to alleviate pain and restore function. This procedure is particularly relevant for patients suffering from severe joint instability, arthritis, or other degenerative conditions that compromise the integrity of the shoulder joint. The surgery involves the use of an autogenous graft, which is a piece of bone taken from the patient's own body, to facilitate the fusion process. The procedure is performed through a deltopectoral approach, which allows the surgeon to access the shoulder joint effectively. During the operation, various anatomical structures, including the deltopectoral interval and the cephalic vein, are identified and managed to ensure optimal exposure of the joint. The surgical technique requires careful manipulation of the shoulder's tendons and ligaments, including the retraction of the conjoint tendon and incision of the subscapularis tendon, to gain access to the joint capsule. The dislocation of the shoulder is performed to enable the removal of cortical bone from the joint surfaces, which is a critical step in preparing the joint for fusion. The harvested autogenous bone graft is then meticulously prepared and placed into the joint space to promote healing and stability. The procedure culminates in the application of fixation devices to secure the joint in its new position, followed by immobilization to support recovery.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The arthrodesis of the glenohumeral joint is indicated for several specific conditions that compromise shoulder function and cause significant pain. These indications include:

  • Severe Joint Instability - This condition may arise from trauma or degenerative diseases, leading to a lack of stability in the shoulder joint.
  • Arthritis - Patients suffering from advanced arthritis, particularly osteoarthritis or rheumatoid arthritis, may require this procedure to alleviate pain and improve joint function.
  • Degenerative Joint Disease - Conditions that lead to the deterioration of joint structures can necessitate fusion to restore stability and reduce discomfort.
  • Failed Previous Shoulder Surgery - Patients who have undergone unsuccessful shoulder surgeries may benefit from arthrodesis as a means to achieve a more stable and pain-free joint.

2. Procedure

The procedure for arthrodesis of the glenohumeral joint involves several critical steps to ensure successful fusion and recovery. The steps are as follows:

  • Step 1: Deltopectoral Approach - The surgeon begins by making an incision to access the shoulder joint through the deltopectoral interval. This approach allows for optimal exposure of the joint while minimizing damage to surrounding tissues.
  • Step 2: Identification of Anatomical Structures - Key structures, including the cephalic vein and the conjoint tendon, are identified. The conjoint tendon is carefully retracted medially to provide a clear view of the joint.
  • Step 3: Incision and Joint Exposure - The subscapularis tendon is incised, and the joint capsule is opened to facilitate access to the glenohumeral joint. This step is crucial for the subsequent dislocation of the shoulder.
  • Step 4: Joint Dislocation - The shoulder is dislocated to allow for the removal of cortical bone from the joint surfaces, specifically the acromion, glenoid fossa, and humeral head. This preparation is essential for the fusion process.
  • Step 5: Harvesting the Autogenous Graft - If an autogenous bone graft is required, it is harvested either locally or from a remote site, such as the iliac crest. The graft is then prepared for placement into the joint space.
  • Step 6: Placement of the Bone Graft - The prepared bone graft is inserted into the joint space to facilitate fusion. The humerus is then returned to the joint socket, ensuring proper alignment.
  • Step 7: Positioning and Fixation - The humeral head is subluxated upward to ensure contact with the acromion. The arm is positioned with abduction and flexion, and the alignment is assessed before fixation devices are applied.
  • Step 8: Application of Fixation Devices - A plate is contoured to fit the patient's anatomy and is placed along the spine of the scapula, extending down onto the humeral shaft. Compression screws are inserted through the humeral head into the glenoid fossa to secure the plate, with additional screws placed as necessary.
  • Step 9: Immobilization - Finally, the shoulder is immobilized using a shoulder spica cast to support the healing process and maintain the position of the joint during recovery.

3. Post-Procedure

Post-procedure care following arthrodesis of the glenohumeral joint is critical for successful recovery. Patients are typically advised to keep the shoulder immobilized in a shoulder spica cast for a specified duration to promote healing and stability. Pain management strategies may be implemented to address discomfort during the recovery phase. Regular follow-up appointments are essential to monitor the healing process and assess the success of the fusion. Rehabilitation exercises may be introduced gradually, focusing on restoring range of motion and strength while ensuring that the joint remains stable. The overall recovery timeline can vary based on individual patient factors, but adherence to post-operative instructions is vital for optimal outcomes.

Short Descr ARTHRD GLENOHUMERAL JT W/GRF
Medium Descr ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT
Long Descr Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 162 - Other OR therapeutic procedures on joints
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
Date
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2023-01-01 Note Short description changed.
Pre-1990 Added Code added.
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