CPT 29086 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • GO - Services delivered under an outpatient occupational therapy plan of care • RT - Right side of body |
| Complexity Level | Low |
National average reimbursement for CPT 29086 by major payers:

$95.99

$99.70

$102.63

$128.76
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 29086 | ||||||
United | 29086 | $344.00 | 1902834922 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $150.00 | 1255792453 - MIDWEST EYE CONSULTANTS OHIO, INC, CATARACT & LASER INSTITUTE #351 | 300888250 - (OH) MIDWEST EYE CONSULTANTS OHIO INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $2079.00 | 1508837899 - MEMORIAL HERMANN SURGERY CENTER NORTHWEST, LLP, MEMORIAL HERMANN SURGERY CENTER GREATER HEIGHTS | 200689650 - (TX) MEMORIAL HERMANN SURGERY CENTER NORTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $574.00 | 1245263292 - CHATTANOOGA PAIN MANAGEMENT CENTER LLC, CHATTANOOGA PAIN SURGERY CENTER | 320121593 - (TN) CHATTANOOGA PAIN MANAGEMENT | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $425.00 | 1124026422 - CHARLESTON ENT ASSOCIATES, LLC, SURGERY CENTER OF CHARLESTON | 582281023 - (SC) CHARLESTON ENT ASSOCIATES, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $566.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $624.00 | 1649233180 - WEST PARK SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/MCKINNEY | 800002697 - (TX) WEST PARK SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $200.00 | 1467557678 - BEAN CENTER FOR FOOT SURGERY INC, SIERRA CENTER FOR FOOT SURGERY | 880309955 - (NV) BEAN CENTER FOR FOOT SURGERY INC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $63.43 | 1942997473 - BRITTANY MURRAY | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 29086 | $531.00 | 1194239483 - ATLANTIC COAST SURGICAL SUITES, LLC | 822449256 - (NH) ATLANTIC COAST SURGICAL SUITES LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $125.00 | 1891728382 - MISSISSIPPI COAST ENDOSCOPY & AMBULATORY CENTER LLC, MISSISSIPPI COAST ENDOSCOPY & AMBULATORY SURGICAL | 640927074 - (MS) MISSISSIPPI COAST ENDOSCOPY AND AMBULATORY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $1096.00 | 1902204654 - DENVER SURGICENTER, LLC | 472340660 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $555.00 | 1568867075 - POTOMAC VIEW SURGERY CENTER, LLC | 471352116 - (MD) POTOMAC VIEW SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $135.00 | 1326374844 - CREEKSIDE SURGERY SUITE | 680319558 - (CA) SHAHRIAR MABOURAKH, M.D. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29086 | $400.00 | 1750948873 - ERIE SHORES SURGERY CENTER LLC | 834395754 - (OH) ERIE SHORES SURGERY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 29086 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29086 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 29086 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 29086. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29086 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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