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See a sample rate comparisonCPT 29819 Fee Schedule
Medicare rates as of October 2026
CPT 29819 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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 | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | 59Distinct Procedural Service RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5113 - Level 3 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Add-on Codes | 29826 |
| Common Revenue Codes | 03600960Sign up to view all 4 |
| Medicare Fee Schedule | $550.11 national non-facility rate (2026)View Medicare rates for 29819 |
| Medicaid Fee Schedule | $440.305 median of the 8 states in the free previewView Medicaid rates for 29819 |
National average reimbursement for CPT 29819 by major payers:
$830.95
BCBS / Anthem
$794.43
UnitedHealthcare
$822.93
Aetna
$970.60
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 29819.
CPT 29819
5 of 25 sample ratesHigher to lower in this preview
Mid-State Endoscopy Center LLC
Midstate Endoscopy Center LLC
$6,492.00Published rateRiver Drive Surgery Center, LLC, River Drive Surgery And Laser Center
River Drive Surgery Center L L
$4,170.00Published rateAesculapian Surgery Center, LLC, Intercoastal Medical Group Ambulatory Surgery Center
Aesculapian Surgery Center LLC
$2,570.00Published rateRaghav Gupta
Deaconess Hospital Inc
$1,020.17Published rateBama Heart Doc, P.C., Alabama Heart And Vascular Medicine
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$628.59Published rate
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See a sample payer proposalCPT 29819 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 29819. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 29805-CPT | 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 | 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 | 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 | 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 29819. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29819 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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Frequently Asked Questions
What APC is CPT 29819 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 29819 to APC 5113 (Level 3 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 29819 in an ambulatory surgery center?
CMS lists CPT 29819 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which add-on codes are billed with CPT 29819?
CMS add-on code edits list CPT 29819 as a primary code for these add-on codes: 29826.
Which revenue codes are billed with CPT 29819?
Hospital price transparency files list CPT 29819 under these revenue codes: 0360, 0960, 0975 and 0361. A revenue code names the hospital department or charge category for the line; it does not change what the service is.