CommercialCoverageMedium impact
Balloon Spacers for Treatment of Irreparable Rotator Cuffs of the Shoulder
Blue Cross & Blue Shield of Mississippi·MS · Orthopedics, Sports Medicine·Medical Policy
Effective date
Aug 15, 2025
We identified it
Jun 20, 2026
Summary
BCBS has classified subacromial balloon spacer implantation for massive irreparable rotator cuff tears as investigational and not covered. This affects billing for the InSpace balloon spacer device and related arthroscopic procedures for rotator cuff tears.
Action Required
By August 15, 2025: Billing team must flag CPT 29999 and HCPCS C9781 as non-covered investigational procedures for BCBS plans when used for subacromial balloon spacer implantation. Update prior authorization systems to automatically deny these procedures for rotator cuff tear treatment. Providers should be informed that these procedures will be denied and patients may need alternative treatment options or self-pay arrangements.