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 |
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 | $3150.00 | 1023072824 - SOUTH JERSEY EYE PHYSICIANS, LLC, THE SURGICAL CENTER AT SOUTH JERSEY EYE PHYSICIANS, PA | 222116946 - (NJ) SOUTH JERSEY EYE PHYSICIANS, PA | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $6026.00 | 1245482280 - NORTHWEST AMBULATORY SURGERY CENTER LLC, NORTHWEST AMBULATORY SURGERY CENTER | 263548852 - (OR) NORTHWEST AMBULATORY SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $4070.00 | 1548613755 - VERO BEACH FLORIDA ASC LLC, SEBASTIAN RIVER SURGERY CENTER | 300936810 - (FL) VERO BEACH FLORIDA ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $2764.00 | 1497740872 - SHASTA EYE SURGEONS INC, SURGERY CENTER OF NORTHERN CALIFORNIA | 205757123 - (CA) SHASTA EYE SURGEONS INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $1991.00 | 1083050603 - CORTLAND ASC, LLC, CORTLAND SURGICAL CENTER | 461344196 - (NY) CORTLAND ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $1169.00 | 1386793370 - SURGERY CENTER OF WEST MONROE, LLC | 721509507 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $3240.00 | 1154718070 - FERTILITY LAB SCIENCES OF MINNEAPOLIS, LLC | 465432360 - (MN) FERTILITY LAB SCIENCES OF MINN | MN | 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 | $2407.00 | 1578898276 - SOUTHERN UROLOGY SURGERY CENTER, LLC | 270881751 - (MS) SOUTHERN UROLOGY SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $7888.00 | 1245711803 - SURGCENTER CLEARWATER, LLC, SURGCENTER DUNEDIN | 823682684 - (FL) SURGCENTER CLEARWATER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $4100.00 | 1033635206 - MEDSTAR SURGERY CENTER AT TIMONIUM, LLC | 821874292 - (MD) MEDSTAR SURGERY CENTER AT TIMO | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $1275.00 | 1093395501 - COLUMBUS ONE ENDOSCOPY LLC, HILLIARD ENDO CENTER | 824347730 - (OH) COLUMBUS ONE ENDOSCOPY LLC | OH | 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 | $1339.00 | 1073818654 - ROYAL OAK SURGICAL CENTER, LLC, ROYAL OAK SURGICAL CENTER PLLC | 320323562 - (MI) ROYAL OAK SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29866 | $2993.00 | 1558475210 - SURGICAL SPECIALTY ASSOCIATES LLC, DOCTORS SAME DAY SURGERY CENTER LLC | 721459017 - (LA) SURGICAL SPECIALTY ASSOCIATES | LA | 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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