CPT 29904 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 29904 |
National average reimbursement for CPT 29904 by major payers:

$843.01

$845.82

$868.08

$1,077.11
| 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 29904 | ||||||
United | 29904 | $4192.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $595.00 | 1750333746 - NORTH PINELLAS SURGERY CENTER LLC | 593759228 - (FL) NORTH PINELLAS SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $2400.00 | 1316009194 - ADVOCATE SOUTHWEST AMBULATORY SURGERY CENTER LLC, TINLEY WOODS SURGERY CENTER | 364437931 - (IL) ADVOCATE SOUTHWEST AMBULATORY SURGE | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $6623.00 | 1548844400 - SAINT LUKES SOUTH PAIN MANAGEMENT CENTER LLC | 863451115 - (KS) SAINT LUKES SOUTH PAIN MANAGEMENT CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1457.00 | 1235112814 - MT PLEASANT SURGICAL CENTER, LLC, MT PLEASANT SURGICAL CENTER | 752691365 - (TX) MT PLEASANT SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1567.00 | 1093786501 - SURGERY CENTER OF EASTON LP, HEALTHSOUTH SURGERY CENTER OF EASTON, L.P. | 721349755 - (MD) SURGERY CENTER OF EASTON LP | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $2204.00 | 1265679674 - GEORGIA UROLOGY FAYETTE ASC | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $4884.00 | 1316449168 - SURGERY CENTER AT ST. VINCENT, LLC, EAST PAVILION SURGERY CENTER | 813129674 - (OR) SURGERY CENTER AT ST VINCENT LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1100.00 | 1104228931 - GLENNVILLE EYE SURGERY CENTER LLC | 463019697 - (GA) GLENNVILLE EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $6225.00 | 1306472063 - THE EMORY CLINIC INC, EMORY ENDOSCOPY CENTER AT DECATUR | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1167.02 | 1013984657 - MAYFAIR DIGESTIVE HEALTH CENTER, LLC | 50525982 - (WI) MAYFAIR DIGESTIVE HEALTH CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $3623.00 | 1174802045 - LEONARDTOWN SURGERY CENTER LLC | 452019132 - (MD) LEONARDTOWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1391.00 | 1376774208 - DIGESTIVE DISEASES DIAGNOSTIC & TREATMENT CENTER LLC | 261319443 - (NY) DIGESTIVE DISEASES DIAGNOSTIC TREATMENT CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $6904.00 | 1598769481 - MEMORIAL HERMANN SURGERY CENTER PRESTON ROAD, LTD., DOCTORS UNITED SURGERY CENTER | 752832459 - (TX) MEMORIAL HERMANN SURGERY CENTER PRESTON ROAD LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1500.00 | 1467544684 - TOWNE CENTRE SURGERY CENTER, LLC, ST. MARY'S OF MICHIGAN | 204943843 | MI | 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 29904 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29904 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 29904 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 |
|---|---|---|
| 29900-CPT | Moderate | Arthroscopy, Metacarpophalangeal Joint, Diagnostic, Includes Synovial Biopsy |
| 29901-CPT | Moderate | Arthroscopy, Metacarpophalangeal Joint, Surgical; With Debridement |
| 29904-CPT | Moderate | Subtalar Arthro W/Fb Rmvl |
| 29905-CPT | Moderate | Arthroscopy Subtalar Joint 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 29904. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29904 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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