CPT 29828 Fee Schedule
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.
| 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 29828 |
National average reimbursement for CPT 29828 by major payers:
$1,183.58
$1,228.85
$1,300.00
$1,543.05
| 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 29828 | ||||||
United | 29828 | $3042.00 | 1083144653 - GREATER PITTSBURGH SURGERY LLC | 821512721 - (PA) GREATER PITTSBURGH SURGERY LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $5298.00 | 1811003205 - VIEWMONT SURGERY CENTER, LLC | 201133583 - (NC) VIEWMONT SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $5100.00 | 1275546434 - MOUNTAIN VIEW ENDOSCOPY CENTER LP | 201417318 - (CA) MOUNTAIN VIEW ENDOSCOPY CENTER, | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $860.00 | 1407801509 - ATLANTIC SURGERY CENTER,LLC | 223625894 - (NJ) ATLANTIC SURGERY CENTERLLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $2816.00 | 1508839473 - NEWARK ENDOSCOPY ASC LLC, ENDOSCOPY CENTER OF DELAWARE | 621867825 - (DE) NEWARK ENDOSCOPY ASC LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $1775.00 | 1962455964 - CYPRESS SURGERY CENTER LLC | 481214301 - (KS) CYPRESS SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $2295.00 | 1679556864 - DOCTORS GI PARTNERSHIP LTD, HF SURGERY CENTER AT BABCOCK | 593758988 - (FL) DOCTORS GI PARTNERSHIP LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $6087.00 | 1881697522 - RIVERSIDE PARK SURGICENTER LLC | 593106055 - (FL) RIVERSIDE PARK SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $5851.00 | 1194727883 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE PUGET SOUND SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $732.10 | 1316454002 - KENNETH WATSON | 350593390 - DEACONESS HOSPITAL INC | GA | Certified Registered Nurse Anesthetist (367500000X) |
United | 29828 | $1593.41 | 1619912979 - PATRICIA COPLEY | 350593390 - DEACONESS HOSPITAL INC | TX | Pulmonary Disease Physician (207RP1001X) |
United | 29828 | $2297.00 | 1083694319 - KINGS EYE CENTER MEDICAL GROUP, INC., KINGS EYE SURGICAL CENTER | 770566388 - (CA) KINGS EYE CENTER MEDICAL GROUP, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $1593.41 | 1790275766 - SPENCER GREENWOOD | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 29828 | $742.00 | 1073579256 - OUTPATIENT SURGICAL CARE LTD | 860525610 - (AZ) OUTPATIENT SURGICAL CARE LTD | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29828 | $3458.00 | 1215302906 - RADIUS SURGERY CENTER LLC | 474627643 - (GA) RADIUS SURGERY CENTER LLC | GA | 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 29828 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29828 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 29828 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 |
| 29828-CPT | High | Release Of Tendon Connecting Biceps Muscle And Shoulder Using An Endoscope |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 29828. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29828 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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