2025 CPT code 29827
(Active) Effective Date: N/A Revision Date: N/A Surgery - Arthroscopy Musculoskeletal System Feed
Arthroscopy, shoulder, surgical; with rotator cuff repair.
Modifiers may be necessary depending on the circumstances of the procedure, such as modifier 51 for multiple procedures, 59 for distinct procedural services, and 76 for repeat procedures. Consult current NCCI edits for specific guidance.
Medical necessity for arthroscopic rotator cuff repair is established through clinical findings demonstrating a significant rotator cuff tear causing pain, weakness, and limitation of shoulder function.Conservative treatment (e.g., physical therapy, medication) should have failed or be deemed inappropriate before considering surgical intervention.Payer specific criteria may also be considered.
The orthopedic surgeon or qualified healthcare professional is responsible for performing the arthroscopy, including making the incisions, inserting and manipulating the arthroscope and surgical instruments within the shoulder joint to assess the rotator cuff, performing the repair, irrigating the joint, achieving hemostasis, and closing the incisions. Postoperative care and follow up may be included in the global surgical package, depending on payer guidelines.
In simple words: The doctor uses a small camera (arthroscope) to look inside the shoulder joint and repair a torn rotator cuff (the muscles and tendons that support the shoulder). This is a minimally invasive procedure with small incisions.
This CPT code encompasses surgical arthroscopy of the shoulder, specifically involving the repair of a rotator cuff tear.The procedure utilizes an arthroscope to visualize the joint, followed by the use of additional instruments for the repair of the tear.The code includes the insertion and removal of the arthroscope and ancillary instruments, irrigation, hemostasis, and closure of the incisions. For open or mini-open rotator cuff repair, use 23412. When arthroscopic distal clavicle resection is performed at the same setting, use 29824 and append modifier 51.
Example 1: A 45-year-old male professional baseball player presents with chronic right shoulder pain and weakness, particularly during overhead throwing.Arthroscopy reveals a full-thickness tear of the supraspinatus tendon. The surgeon performs a rotator cuff repair using suture anchors., A 60-year-old female reports progressive right shoulder pain and limited range of motion for the past six months. Arthroscopy reveals a partial-thickness tear of the rotator cuff and significant subacromial impingement.The surgeon performs a rotator cuff debridement and repair along with subacromial decompression., A 28-year-old female sustains a fall and presents with acute left shoulder pain and limited movement. Arthroscopy shows a complete tear of the rotator cuff and a labral tear. The surgeon performs a rotator cuff repair and labral debridement.
Preoperative and postoperative physical examinations documenting the extent of the rotator cuff tear and range of motion, intraoperative photographs or video documenting the arthroscopic findings and surgical repair, operative report detailing the surgical procedure, including type of repair, implants used, and estimated blood loss, and postoperative physical therapy notes indicating progress toward regaining full range of motion.
** Accurate coding requires comprehensive documentation that supports medical necessity.Always refer to the most current coding guidelines and payer-specific requirements.
- Payment Status: Active
- Modifier TC rule: The technical component (TC) modifier may apply depending on the services rendered.Refer to payer specific guidelines.
- Fee Schedule: Information on historical fee schedules can be obtained from relevant payer websites or fee schedule databases. These data will vary widely based on geographic location and payer contract.
- Specialties:Orthopedic Surgery
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient, Office