CPT 29866 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 29866 |
National average reimbursement for CPT 29866 by major payers:
$1,424.15
$1,417.86
$1,455.23
$1,777.62
| 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 29866 | ||||||
United | 29866 | $4077.00 | 1669787958 - PINE RIDGE SURGERY CENTER, LLC | 271609169 - (WI) PINE RIDGE SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $1342.00 | 1194718312 - CAPE COD ASC LLC | 43424805 - (MA) CAPE COD ASSOC LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $10360.00 | 1306351887 - BELTWAY SURGERY CENTERS, LLC, MERIDIAN SOUTH SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $2035.00 | 1942202221 - NORTHLAKE ENDOSCOPY, LLC | 721515370 - (LA) NORTHLAKE ENDOSCOPY LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $6429.00 | 1952333882 - THE MARYLAND CENTER FOR DIGESTIVE HEALTH LLC | 470856276 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $4388.00 | 1639498579 - INTERVENTIONAL SPINE CENTER, LLC | 263161503 - (CA) INTERVENTIONAL SPINE CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $5300.00 | 1528145778 - OVERLAKE AMBULATORY SURGERY CENTER, LLC, OVERLAKE SURGERY CENTER LLC | 911925618 - (WA) OVERLAKE AMBULATORY SURGERY CENTER, | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $3861.00 | 1982641064 - PIONEER VALLEY SURGICENTER LLC, PIONEER VALLEY SURGICENTER | 10740204 - (MA) PIONEER VALLEY SURGICENTER, LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $3000.00 | 1154873594 - AMERICAN ACCESS CARE OF PENNSYLVANIA ASC LLC | 814056190 - (PA) AMERICAN ACCESS CARE OF PENNSYLVANIA ASC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $14886.00 | 1730126863 - ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, ST. DAVID'S MEDICAL CENTER | 742781812 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $3236.00 | 1912252693 - ROCKWOOD CLINIC PS, ROCKWOOD EYE SURGERY CENTER | 911352172 - MULTICARE HEALTH SYSTEM | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $8818.00 | 1619093218 - CLEBURNE SURGICAL CENTER, LLC | 203742012 - (TX) CLEBURNE SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $3289.00 | 1114965803 - ADVANCED ENDOSCOPY & SURGICAL CENTER LLC, ADVANCED ENDOSCOPY & SURGICAL CENTER | 113660090 - (NJ) ADVANCED ENDOSCOPY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $5839.00 | 1346207875 - GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | 364053840 - (NC) GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $1073.00 | 1437129723 - AFFINITY OUTPATIENT SERVICES | 582189333 - (GA) AFFINITY HEALTH GROUP, L.L.C. | 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 29866 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29866 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 29866 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 |
|---|---|---|
| 29866-CPT | High | Arthroscopy, Knee, Surgical; Osteochondral Autograft - Medicaid Rn Review>=6/13/2009. Commercial Rn Review=6/13/2009-3/31/2022 |
| 29867-CPT | High | Arthroscopy, Knee, Surgical; Osteochondral Allograft (Eg, Mosaicplasty) |
| 29868-CPT | High | Arthroscopy, Knee, Surgical; Meniscal Transplantation, Medial Or Lateral - Medicaid Rn Review>=11/14/2009. Commercial Rn Review=11/14/2009-3/31/2022 |
| 29877-CPT | Moderate | Arthroscopy,Knee,Surg;Debride/Shave A.Ca |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 29866. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29866 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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