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 |
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 | $1119.00 | 1922486679 - ST LOUIS SPECIALTY SURGICAL CENTER, LLC | 611754451 - (MO) ST LOUIS SPECIALTY SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $3276.00 | 1417114117 - HOSP OF THE UNIV OF PA SPU | 231352685 - TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1419.00 | 1841954054 - SOUTHERN PLAINS MEDICAL CENTER SPMC-ASC, SPMC-ASC | 872964092 - (OK) SOUTHERN PLAINS MEDICAL CENTER SPMCASC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $4143.10 | 1578208435 - NPI SURGERY CENTER LLC | 852578527 - (NE) NPI SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1109.00 | 1982186425 - CENTER FOR SPINE & PAIN MEDICINE PC, CSPM GSV ASC | 341976829 - CENTER FOR SPINE AND PAIN MEDICI | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $669.00 | 1215118930 - DELPHOS AMBULATORY SURGERY CENTER INC, DELPHOS ASC | 208412630 - (OH) DELPHOS AMBULATORY SURGERY CENTER INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $3570.00 | 1174802045 - LEONARDTOWN SURGERY CENTER LLC | 452019132 - (MD) LEONARDTOWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1021.00 | 1225050347 - STATE HILL SURGICENTER LLC | 203106650 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $771.00 | 1225077241 - CORTEZ FOOT SURGERY CENTER, P.A. | 650064196 - (FL) CORTEZ FOOT SURGERY CENTER PA | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $2700.00 | 1952071920 - LAKEVIEW SURGERY CENTER, LLC | 872359088 - (FL) LAKEVIEW SURGERY CENTER LLC | FL | 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 | $897.00 | 1710591060 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC | 272910652 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $631.00 | 1487871331 - GYNEMED SURGICAL CENTER | 521921544 - (MD) GYNEMED SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1400.00 | 1265816003 - CLEARVIEW SURGERY CENTER, LLC | 474123527 - (ID) CLEARVIEW SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 29904 | $1100.00 | 1972549491 - UNION CITY ASC LLC, SUMMIT ENDOSCOPY CENTER | 621625423 | TN | 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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