In 2016, AANA leadership worked with CMS to formally unbundle the shoulder arthroscopic debridement codes. The unbundling of shoulder debridement codes allows AANA members to be compensated for additional work, when treating multiple surgical pathologies in the shoulder region. Despite this regulatory win, the 2017 NCCI coding manual still refers to the shoulder as “a single anatomic structure”. We believe that this language is anatomically inaccurate and may expose certain procedures to future reimbursement risk. It is vital that CMS recognize that the shoulder region contains distinct anatomic compartments, each with unique pathology and surgical treatment options. At the 2018 NOLC, AANA leadership submitted joint resolution with ASES, requesting that the AAOS recognize the shoulder to contain 5 distinct anatomic compartments: the glenohumeral joint, the subacromial space, the acromioclavicular joint. While this resolution serves a first step, work remains to change the language used by CMS, and the AANA Advocacy team will continue discussions with CMS on this important advocacy issue.