CPT 29861 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 |
| Medicare Fee Schedule | View Medicare rates for 29861 |
National average reimbursement for CPT 29861 by major payers:
$967.74
$969.14
$1,029.34
$1,203.07
| 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 29861 | ||||||
United | 29861 | $4570.00 | 1679001028 - CENTERVIEW SURGERY CENTER, LLC | 815461133 - (AR) CENTERVIEW SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29861 | $9956.00 | 1619995180 - MED CITY DALLAS OUTPATIENT SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DALLAS | 201043104 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29861 | $7229.00 | 1154474583 - CREEKWOOD SURGERY CENTER, LP | 431656044 - (MO) CREEKWOOD SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29861 | $1257.02 | 1316466774 - HASAN ALBITAR | 350593390 - DEACONESS HOSPITAL INC | IN | Pulmonary Disease Physician (207RP1001X) |
United | 29861 | $1257.02 | 1205891405 - JANINE KRAMER | 350593390 - DEACONESS HOSPITAL INC | NY | Emergency Medicine Physician (207P00000X) |
United | 29861 | $4189.00 | 1366044596 - PEGASUS SURGERY CENTER LLC, PEGASUS SURGERY CENTER, LLC | 301211930 - (CA) PEGASUS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29861 | $5754.00 | 1255353389 - SOMERSET AMBULATORY SURGICAL CENTER, LLC | 371743209 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29861 | $4170.00 | 1144275900 - MT LAUREL ENDOSCOPY CENTER L P | 562350370 - (NJ) MT LAUREL ENDOSCOPY CENTER L P | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29861 | $6588.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29861 | $4704.00 | 1750347472 - BAYLOR SURGICARE AT NORTH DALLAS, LLC, BAYLOR SCOTT & WHITE SURGICARE-NORTH DALLAS | 752900902 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29861 | $450.82 | 1487771705 - DONNA MEDICAL CLONIC | 223875437 - (TX) DONNA MEDICAL CLINIC, P.A. | TX | General Acute Care Hospital (282N00000X) |
United | 29861 | $2913.00 | 1417987595 - ENDOSCOPY CENTER OF NORTH BALTIMORE | 412081861 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29861 | $5401.91 | 1417941295 - UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER | 756001354 | TX | General Acute Care Hospital (282N00000X) |
United | 29861 | $901.00 | 1467010736 - MERCY SURGERY CENTER LLC | 841875159 - (IA) MERCY SURGERY CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29861 | $3226.00 | 1487628301 - SAN ANTONIO TX ENDOSCOPY ASC LP, SAN ANTONIO GASTROENTEROLOGY ENDOSCOPY CENTER | 200075829 - (TX) SAN ANTONIO TX ENDOSCOPY ASC LP | TX | 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 29861 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29861 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 29861 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 |
|---|---|---|
| 29860-CPT | Moderate | Arthroscopy, Hip, Diagnostic W/Wo Synovial Biopsy (Separate Procedure) |
| 29861-CPT | Moderate | Arthroscopy, Hip, Surgical; With Removal Of Loose Body Or Foreign Body |
| 29862-CPT | High | Arthroscopy, Hip, Surgical; With Debridement/Shaving Of Articular Cartilage (Chondroplasty), Abrasion Arthroplasty, And/Or Resection Of Labrum |
| 29863-CPT | High | Arthroscopy, Hip, Surgical; With Synovectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 29861. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29861 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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