The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Shoulder resurfacing arthroplasty.


Degenerative disease (such as osteoarthritis and rheumatoid arthritis) can cause pain in the shoulder, particularly when the arm is moved.

Shoulder resurfacing involves joint replacement surgery (arthroplasty). Using open surgery, the end of the upper arm bone is reshaped, a small anchoring hole is drilled into the bone and an artificial shoulder joint is placed onto it.

Coding recommendations

One of the following codes is used depending on whether cement is used or not, or not known:

W49.4 Resurfacing hemiarthroplasty of head of humerus using cement

W50.4 Resurfacing hemiarthroplasty of head of humerus not using cement

W51.5 Resurfacing hemiarthroplasty of head of humerus NEC

If both the humerus and the glenoid surface of the scapula are resurfaced then the appropriate codes are:

W58.1 Primary resurfacing arthroplasty of joint

Z81.3 Glenohumeral joint

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)