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See a sample rate comparisonCPT 29863 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.
Arthroscopy, Hip, Surgical; With Synovectomy
| 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 29863 |
| Medicaid Fee Schedule | View Medicaid rates for 29863 |
National average reimbursement for CPT 29863 by major payers:
$1,122.49
$1,088.20
$1,138.37
$1,327.60
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CPT 29863
5 of 25 sample ratesHigher to lower in this preview
Northshore Regional Medical Center Dba The Surgery Suite, The Surgery Suite
Ochsner Clinic Foundation
$22,760.00Published rateVhc-I
Vhci
$4,175.00Published rateGeorgia Urology, PA, Georgia Urology Asc Marietta
$3,275.00Published rateMount Dora Ophthalmology Asc LLC, Mid Florida Surgery Center
Mount Dora Ophthalmology Asc LLC
$2,172.00Published rateKingsport Endoscopy Corporation
$425.00Published rate
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See a sample payer proposalCPT 29863 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29863 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 29863 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 | Hip Exam Using A Scope, Exam Of The Hip Joint Using A Scope (Arthroscopy). The Procedure May Include Taking A Sample Of Joint Fluid For Testing (Biopsy). |
| 29861-CPT | Moderate | Arthroscopy Hip Surgical Wi, Arthroscopy Hip Surgical With Removal Of Loose Body Orforeign Body Arthroscopy Hip Surgical With Removal Of Loose Body Or |
| 29862-CPT | High | Hip Arthr0 W Debridement, 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 29863. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29863 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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