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Official Description

Capsulorrhaphy, anterior; with labral repair (eg, Bankart procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

An anterior capsulorrhaphy with labral repair, commonly referred to as the Bankart procedure, is a surgical intervention aimed at addressing instability in the glenohumeral joint, which is the ball-and-socket joint of the shoulder. This procedure is particularly indicated for patients experiencing recurrent anterior dislocations of the shoulder, a condition that can lead to significant pain and functional impairment. The Bankart lesion, which is a specific type of injury characterized by the detachment of the anterior joint capsule from the fibro-cartilaginous glenoid ligament, is a common finding in individuals with this type of shoulder instability. During the procedure, a surgical incision is made over the anterior aspect of the shoulder to access the joint. The surgery involves meticulous dissection to expose critical anatomical structures, including the deltopectoral groove and the coracoid process, which is excised to facilitate access to the joint capsule. The subscapularis muscle is carefully separated from the joint capsule to allow for a thorough repair of the labrum and stabilization of the joint. The procedure not only repairs the damaged labrum but also reinforces the anterior capsule, thereby restoring stability to the shoulder joint and reducing the likelihood of future dislocations.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The anterior capsulorrhaphy with labral repair is indicated for the following conditions:

  • Recurrent Anterior Dislocation of the Shoulder This procedure is performed to address the instability caused by repeated dislocations of the shoulder joint, which can lead to chronic pain and functional limitations.
  • Glenohumeral Joint Instability Patients with instability in the glenohumeral joint, often resulting from previous injuries or trauma, may benefit from this surgical intervention to restore joint stability.
  • Bankart Lesion The presence of a Bankart lesion, characterized by the detachment of the anterior joint capsule from the glenoid, necessitates repair to prevent further dislocations and improve shoulder function.

2. Procedure

The procedure involves several critical steps to ensure effective repair and stabilization of the shoulder joint:

  • Step 1: Incision and Exposure An incision is made over the anterior aspect of the shoulder joint to provide access to the underlying structures. The deltopectoral groove is dissected, and the cephalic vein is carefully exposed and protected to prevent injury during the procedure.
  • Step 2: Coracoid Process Excision The coracoid process is excised using an osteotome, which allows the attached coracobrachialis muscle and the short head of the biceps tendon to retract inferiorly, facilitating better access to the joint capsule.
  • Step 3: Subscapularis Exposure The subscapularis muscle is exposed and separated from the joint capsule to allow for a clear view of the labrum and glenoid rim. A vertical incision is made in the subscapularis lateral to the glenoid rim, creating lateral and medial flaps for further manipulation.
  • Step 4: Labrum Repair The humeral head is retracted to provide access to the labrum, which is then trimmed and repaired as necessary to restore its integrity and function.
  • Step 5: Glenoid Preparation The rim of the glenoid and the anterior neck of the scapula are smoothed using an osteotome to prepare for the attachment of the capsular flaps.
  • Step 6: Suture Placement Three holes are drilled into the anterior glenoid rim, and a suture is passed through each hole and then through the lateral capsular flap. The sutures are tied to secure the lateral flap to the anterior glenoid rim.
  • Step 7: Medial Flap Attachment The same sutures used for the lateral flap are then utilized to tie down the medial capsular flap over the lateral flap, ensuring a secure and stable repair.
  • Step 8: Reattachment of Subscapularis The subscapularis muscle is reattached to the lesser tuberosity, restoring its anatomical position and function.
  • Step 9: Coracoid Anchoring The coracoid process is anchored using sutures at its base to provide additional stability to the shoulder joint.
  • Step 10: Closure Finally, the overlying tissues are closed in layers, and a dressing is applied to protect the surgical site and promote healing.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any complications and ensuring proper healing of the surgical site. Patients are typically advised to follow a rehabilitation program that includes physical therapy to restore range of motion and strength in the shoulder. The recovery process may vary depending on the individual, but it is essential to adhere to the prescribed rehabilitation protocol to achieve optimal outcomes. Follow-up appointments are necessary to assess the healing process and to make any adjustments to the rehabilitation plan as needed.

Short Descr REPAIR SHOULDER CAPSULE
Medium Descr CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR
Long Descr Capsulorrhaphy, anterior; with labral repair (eg, Bankart procedure)
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 Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
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.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
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.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
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
LT Left side (used to identify procedures performed on the left side of the body)
PT Colorectal cancer screening test; converted to diagnostic test or other procedure
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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