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See a sample rate comparisonCPT 29806 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery To Repair Shoulder, Surgery Aided By A Scope (Arthroscopy) To Repair The Shoulder Joint. The Procedure Removes Loose Tissue Or Foreign Objects As Well As Repairing Torn Cartilage Or Tissue.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 29806 |
| Medicaid Fee Schedule | View Medicaid rates for 29806 |
National average reimbursement for CPT 29806 by major payers:
$1,487.73
$1,433.50
$1,533.30
$1,736.36
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CPT 29806
5 of 25 sample ratesHigher to lower in this preview
Marc Philippon
$6,117.10Published rateMichelle Dudevoir
$2,288.89Published rateBennie Lindeque
$1,829.61Published rateHayden Schuette
$1,715.00Published rateMichael Hewitt
$881.73Published rate
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See a sample payer proposalCPT 29806 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29806 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 29806 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.
| Code | Complexity | Description |
|---|---|---|
| 29805-CPT | Moderate | Scope Exam Of Shoulder, Exam Of A Shoulder Using A Scope (Arthroscopy). The Procedure May Include Taking A Sample Of Tissue For Testing (Biopsy). |
| 29806-CPT | High | Surgery To Repair Shoulder, Surgery Aided By A Scope (Arthroscopy) To Repair The Shoulder Joint. The Procedure Removes Loose Tissue Or Foreign Objects As Well As Repairing Torn Cartilage Or Tissue. |
| 29807-CPT | High | Surgery To Repair Shoulder, Surgery Aided By A Scope (Arthroscopy) To Repair The Shoulder Joint. The Procedure Removes Loose Tissue Or Foreign Objects As Well As Repairing Torn Cartilage Or Tissue. |
| 29819-CPT | Moderate | Surgery To Repair Shoulder, Surgery Aided By A Scope (Arthroscopy) To Repair The Shoulder Joint. The Procedure Removes Loose Tissue Or Foreign Objects As Well As Repairing Torn Cartilage Or Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 29806. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29806 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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