CPT 29867 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 29867 by major payers:
$1,798.75
$1,722.96
$1,774.61
$2,157.99
| 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 29867 | ||||||
United | 29867 | $2692.00 | 1316926405 - MIRACLE HILLS SURGERY CENTER LLC | 204464406 - (NE) MIRACLE HILLS SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $3582.00 | 1275281370 - MASS GENERAL BRIGHAM AMSURG INC. | 854372153 - (NH) MASS GENERAL BRIGHAM INCORPORATED | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $1645.00 | 1144334962 - HEIGHTS SURGERY CENTER, INC., HEIGHTS SURGEY CENTER | 760402839 - (TX) HEIGHTS SURGERY CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $2423.00 | 1346322187 - XRS LLC, COLUMBUS PAIN INSTITUTE | 201384877 - (IN) XRS LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $3169.00 | 1861059818 - FISHERS SPECIALTY SURGERY CENTER, LLC, ORTHOALLIANCE OF INDIANA | 833241405 - (IN) FISHERS SPECIALTY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $6588.00 | 1891298089 - MICHIGAN OUTPATIENT SURGICAL SOLUTIONS, LLC | 821706937 - (MI) MICHIGAN OUTPATIENT SURGICAL SOLUTIONS LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $3605.00 | 1184072308 - MARYLAND SURGERY CENTER FOR WOMEN | 522215638 - (MD) MARYLAND SURGERY CENTER FOR WOMEN, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $3739.00 | 1437642857 - GEORGIA VASCULAR & VEIN CENTER | 822239594 - (GA) GEORGIA VASCULAR VEIN CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $3871.00 | 1174258107 - FW SPECIALTY SURGICARE, LLC | 854261198 - (TX) FW SPECIALTY SURGICARE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $3044.00 | 1750663084 - PNW EYE PLLC, PACIFIC NORTHWEST EYE SURGERY CENTER | 453155522 - (WA) PNW EYE, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $3100.00 | 1427577840 - DIALYSIS ACCESS CENTER OF CINCINNATI, INC. | 815023998 - (OH) DIALYSIS ACCESS CENTER OF CINCINNATI INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $7620.00 | 1104301613 - LOGAN SURGICAL SUITES LLC, ADVANCED SURGERY CENTER OF NORTHERN UTAH | 822435405 - (UT) LOGAN SURGICAL SUITES LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $4774.00 | 1912199258 - SURGICARE SURGICAL ASSOCIATES OF RIDGEWOOD, LLC | 203728835 - (NJ) SURGICARE SURGICAL ASSOCIATES OF RIDGEWOOD LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $5846.00 | 1144333881 - NORTH SCOTTSDALE AMBULATORY SURGERY CENTER, LLC | 200554616 - (AZ) NORTH SCOTTSDALE AMBULATORY SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29867 | $2684.00 | 1346287232 - MODESTO SURGERY CENTER | 770394007 | CA | 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 29867 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29867 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 29867 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 |
| 29879-CPT | Moderate | Arthroscopy, Knee, Surgical; Abrasion Arthroplasty (Includes Chondroplasty Where Necessary) Or Multiple Drilling Or Microfracture |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 29867. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29867 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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