CPT 29868 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 29868 by major payers:

$2,200.68

$2,266.71

$2,397.62

$2,804.33
| 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 29868 | ||||||
United | 29868 | $999.00 | 1619114824 - EAST COLUMBUS SURGERY CENTER LLC | 311641652 - (OH) EAST COLUMBUS SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $2641.00 | 1326182197 - NACOGDOCHES COUNTY HOSPITAL DISTRICT, NACOGDOCHES MEMORIAL HOSPITAL DAY SURGERY | 871142127 - (TX) LION STAR NACOGDOCHES HOSPITAL, LLC DBA NACOGDOCHES MEMORIAL HOSPITAL | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $1293.00 | 1114312659 - UNITED SHOCKWAVE SERVICES, LTD., UNITED THERAPIES | 363415474 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $2911.00 | 1023036688 - BAYSIDE AMBULATORY CENTER, LLC | 510438152 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $860.00 | 1891406328 - CEI PHYSICIANS PSC, LLC | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $1486.00 | 1811059306 - PENINSULA EYE CENTER, P.A, PENINSULA CATARACT & LASER CENTER | 520974706 - (MD) PENINSULA EYE CENTER PA | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $4401.00 | 1235393356 - PHYSICIANS OUTPATIENT SURGERY CENTER LLC | 352325646 - (FL) PHYSICIANS OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $1644.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $2055.00 | 1689624793 - SURGERY CENTER OF SOUTHWEST FLORIDA INC | 843798404 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $954.00 | 1033162631 - EYE SURGERY CENTER-NORTHLAND LLC | 201938574 - (MO) EYE SURGERY CENTERNORTHLAND LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $7415.00 | 1295209286 - OCONEE SURGERY CENTER | 832067040 - (GA) OCONEE SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $1500.00 | 1528297140 - ISPM ASC AT COVINGTON, LLC | 264485600 - (GA) ISPM ASC AT COVINGTON LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $1000.00 | 1164516084 - ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE INC | 113530475 - (NY) ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $5500.00 | 1376054007 - HUDSON YARDS SURGERY CENTER, LLC, HUDSON SPECIALTY SURGERY CENTER | 463753455 - (NY) HUDSON YARDS SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29868 | $6492.00 | 1992706899 - SURGERY CENTER OF PEORIA, LLC, SURGERY CENTER OF PEORIA | 731538768 - (AZ) SURGERY CENTER OF PEORIA LLC | AZ | 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 29868 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29868 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 29868 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 29868. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29868 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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