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See a sample rate comparisonCPT 29855 Fee Schedule
Last Verified: October 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.
Repair Broken Shinbone, Surgery Aided By A Scope (Arthroscope) To Repair A Broken Shinbone. The Bones May Be Moved Into Place Manually Or Held In Place Using Pins Wires Or A Cage Just Below The Knee.
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 29855 |
| Medicaid Fee Schedule | View Medicaid rates for 29855 |
National average reimbursement for CPT 29855 by major payers:
$1,101.56
$1,061.68
$1,080.82
$1,287.78
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CPT 29855
5 of 25 sample ratesHigher to lower in this preview
Asc Of Trinity, Comprehensive Outpatient Joint And Spine Institute
Asc Of Trinity
$10,114.00Published rateTyler Asc, Lp, Tyler Cardiac & Endovascular Surgery Center
$5,000.00Published rateGeorgia Neurosurgical Institute Outpatient Surgery Center, Georgia Neurosurgical Institute Outpatient Surgery Center
Georgia Neurosurgical Institute Outpatient Surgery Center
$3,500.00Published ratePumpkin Patch Ambulatory Surgical Center, LLC, Orlando Avenue Surgery Center, LLC
Pumpkin Patch Ambulatory Surgical Center LLC
$2,300.00Published rateValley Outpatient Surgical Center Inc
$1,063.00Published rate
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See a sample payer proposalCPT 29855 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29855 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 29855 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 |
|---|---|---|
| 29851-CPT | High | Fracture Treatment, Arthroscopically Aided Treatment Of Intercondylar Spine(S) And/Or Tuberosity Fracture(S) Of The Knee With Or Without Manipulation; Without Internal Or External Fixation (Includes Arthroscopy) With Internal Or External Fixation (Includes Arthroscopy) |
| 29855-CPT | High | Repair Broken Shinbone, Surgery Aided By A Scope (Arthroscope) To Repair A Broken Shinbone. The Bones May Be Moved Into Place Manually Or Held In Place Using Pins Wires Or A Cage Just Below The Knee. |
| 29856-CPT | High | Repair Broken Shinbone, Surgery Aided By A Scope (Arthroscope) To Repair A Broken Shinbone. The Bones May Be Moved Into Place Manually Or Held In Place Using Pins Wires Or A Cage Just Below The Knee. |
| 29866-CPT | High | Autgrft Implnt Knee W Scope, Arthroscopy Knee Surgical Osteochondral Autograft S Eg Mosaicplasty Includes Harvesting Of The Autograft S |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 29855. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29855 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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