CPT 29826 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 29826 by major payers:
$325.13
$416.76
$456.46
$428.16
| 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 29826 | ||||||
United | 29826 | $205.00 | 1174929442 - ROSTISLAV DENENBURG | 823017080 - (FL) SIMEDHEALTH, LLC | FL | Podiatrist (213E00000X) |
United | 29826 | $195.69 | 1578974622 - MICHAEL MASHURA | 650213201 - (FL) MELI ORTHOPEDIC CENTER OF EXCELLENC | IN | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 29826 | $555.00 | 1538390539 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29826 | $78.00 | 1801949631 - THIBODAUX SURGERY CENTER, LLC, BAYOU REGION SURGICAL CENTER | 320165642 - (LA) THIBODAUX SURGERY CENTER, LLC DBA BAYOU REGION SURGICAL CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29826 | $112.00 | 1891763157 - HOUMAS OUTPATIENT SURGERY CENTER | 721005613 - (LA) HOUMA OUTPATIENT SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29826 | $306.00 | 1346508520 - FIRST GI ENDOSCOPY AND SURGERY CENTER LLC | 270870899 - (NJ) FIRST GI ENDOSCOPY AND SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29826 | $414.00 | 1073944039 - THE POLYCLINIC, THE POLYCLINIC PLASTIC SURGERY CENTER | 910369070 - (WA) THE POLYCLINIC, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29826 | $133.00 | 1699246181 - DEERBROOK ASC LLC | 823478937 - (TX) DEERBROOK ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29826 | $531.00 | 1104485440 - SURGCENTER OF GREATER JACKSONVILLE, LLC | 832504492 - (FL) SURGCENTER OF GREATER JACKSONVILLE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29826 | $149.71 | 1063866242 - BRIAN ASENCIO | 364730709 - (FL) LUIS G RAMIREZ M D P A | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 29826 | $131.25 | 1053373928 - JOHN PARRINELLO | 650921031 - (FL) JOHN PARRINELLO PA | FL | Podiatrist (213E00000X) |
United | 29826 | $405.73 | 1710129408 - EDWARD JACKSON | 581537752 - EMORY UNIVERSITY | FL | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 29826 | $131.25 | 1134139454 - SHAYNE JENSEN | 61666115 - (FL) GULF COAST PODIATRY, P.A. | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 29826 | $129.75 | 1104899764 - MARK HALL | 650960025 - (FL) MARK E. HALL, DPM, P.A. | FL | Podiatrist (213E00000X) |
United | 29826 | $699.90 | 1043246937 - DAWN CHIU | 591575766 - (FL) CORTEZ FOOT & ANKLE SPECIALISTS, P.A. | FL | Foot Surgery Podiatrist (213ES0131X) |
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 29826 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29826 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 29826 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 |
|---|---|---|
| 29823-CPT | Moderate | Arthroscopy Shoulder Surgical; Debridement Extensive 3 Or More Discrete Structures (Eg Humeral Bone Humeral Articular Cartilage Glenoid Bone Glenoid Articular Cartilage Biceps Tendon Biceps Anchor Complex Labrum Articular Capsule Articular Side Of The Rotator Cuff Bursal Side Of The Rotator Cuff Subacromial Bursa Foreign Body[Ies]) (Desc Rvsd 1/1/21) |
| 29824-CPT | Moderate | Arthroscopy, Shoulder, Surgical; Distal Claviculectomy Including Distal Articular Surface (Mumford Procedure) |
| 29825-CPT | Moderate | Arthroscopy, Shoulder, Surgical; With Lysis And Resection Of Adhesions, With Or Without Manipulation |
| 29826-CPT | Moderate | Arthroscopy, Shoulder, Surgical; Decompression Of Subacromial Space With Partial Acromioplasty, With Coracoacromial Ligament (Ie, Arch) Release, When Performed (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 29826. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29826 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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