W4900: Shoulder hemiarthroplasty (as sole procedure)
For guidance only. Always check the code and obtain authorisation from your insurer before treatment. Other insurers may use different codes and coding rules.
For guidance only. Procedure codes and descriptions on this site are provided for general guidance only and are not a guarantee of insurance cover or payment. Always check the correct code with your surgeon's secretary and obtain authorisation from your insurer before treatment. Insurers shown are examples only. Other insurers are available, and each may use the same, similar or different codes and coding rules.
Insurer listing
| Insurer | Status | Notes |
|---|---|---|
| Bupa | Listed | Listed by Bupa |
| AXA Health | Listed | Listed by AXA Health |
| Vitality | Listed | Listed by Vitality |
| WPA | Listed | Listed by WPA |
Codes that can't be billed with W4900
Neither code can be billed with the other
- W4902: Shoulder hemiarthroplasty with reconstruction for fracture
- W4920: Conversion of hemiarthroplasty to total shoulder replacement
- W4930: Revisional shoulder hemiarthroplasty
- W9040: Injection(s) +/- aspiration, into joint, cyst, bursa - unilateral
- W9030: Injection(s) +/- aspiration, into joint, cyst, bursa with image guidance - unilateral
- W9020: Dynamic arthrogram of joint
W4900 can't be billed with
- W8700: Diagnostic arthroscopic examination of joint, +/- biopsy (not otherwise specified) (as sole procedure)
- W9111: Manipulation of joint (including intra-articular injection) for Frozen Shoulder" (as sole procedure) - bilateral"
- W9112: Manipulation of joint (including intra-articular injection) for Frozen Shoulder" (as sole procedure)"
AXA Health also lists these codes as unacceptable combinations (14)
- A7350: Local anaesthetic blockade of named major nerve or plexus
- W4902: Shoulder hemiarthroplasty with reconstruction for fracture
- T6450: Tenodesis of biceps tendon (as sole procedure)
- W4920: Conversion of hemiarthroplasty to total shoulder replacement
- W4930: Revisional shoulder hemiarthroplasty
- W6522: Primary open reduction of dislocation of small joint
- W9112: Manipulation of joint (including intra-articular injection) for Frozen Shoulder" (as sole procedure)"
- W9040: Injection(s) +/- aspiration, into joint, cyst, bursa - unilateral
- W9020: Dynamic arthrogram of joint
- T7910: Open subacromial decompression and rotator cuff repair +/- excision of distal clavicle
- W9030: Injection(s) +/- aspiration, into joint, cyst, bursa with image guidance - unilateral
- W2830: Removal of internal fixation from bone / joint, excluding K-wires +/- image guidance
- W8700: Diagnostic arthroscopic examination of joint, +/- biopsy (not otherwise specified) (as sole procedure)
- W9111: Manipulation of joint (including intra-articular injection) for Frozen Shoulder" (as sole procedure) - bilateral"
Related codes
- W4930: Revisional shoulder hemiarthroplasty
- W4902: Shoulder hemiarthroplasty with reconstruction for fracture
- W4920: Conversion of hemiarthroplasty to total shoulder replacement
- W9112: Manipulation of joint (including intra-articular injection) for Frozen Shoulder" (as sole procedure)"
- W9111: Manipulation of joint (including intra-articular injection) for Frozen Shoulder" (as sole procedure) - bilateral"
- W8603: Therapeutic arthroscopy of shoulder (as sole procedure)
Frequently asked questions
What is the procedure code for shoulder hemiarthroplasty (as sole procedure)?
The procedure code is W4900: Shoulder hemiarthroplasty (as sole procedure).
Which insurers list W4900?
W4900 is listed by Bupa, AXA Health, Vitality and WPA. Always confirm the code and cover with your insurer.
Can W4900 be billed with other procedures?
The coding rules say W4900 cannot be billed together with 9 other codes, including W4902 (Shoulder hemiarthroplasty with reconstruction for fracture), W4920 (Conversion of hemiarthroplasty to total shoulder replacement), W4930 (Revisional shoulder hemiarthroplasty). See the full list above.
What does my procedure code mean?
For guidance only. Procedure codes and descriptions on this site are provided for general guidance only and are not a guarantee of insurance cover or payment. Always check the correct code with your surgeon's secretary and obtain authorisation from your insurer before treatment. Insurers shown are examples only. Other insurers are available, and each may use the same, similar or different codes and coding rules.
Codes and descriptions are for guidance only. Insurer listing and cover information is taken from each insurer's published schedule and is for guidance only: always confirm the code and cover with the insurer before treatment. This site is not affiliated with CCSD or any insurer. No fees are shown.
Last checked: 2026-10-01