Arthroscopy, shoulder, surgical; with removal of loose body or foreign body

CPT 29819 is the billing code for "Arthroscopy, shoulder, surgical; with removal of loose body or foreign body". For surgical shoulder arthroscopy with removal of loose body or foreign body

Medicare pays approximately $582.24 for CPT 29819 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 29819 has a total RVU of 21.95, broken down as: Work RVU 9.50, Practice Expense RVU 11.50, and Malpractice RVU 0.95. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 29819 include: Indication for surgical arthroscopy; Location and size of loose body; Removal technique; Number of loose bodies removed. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 29819: Includes surgical arthroscopy. Includes removal of loose body or foreign body Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 29819 include: 50 (Bilateral procedure when both shoulders performed same session), 51 (Multiple procedures performed same session), 22 (Increased procedural services for multiple loose bodies). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 29819 is 40-70 minutes typical operative time. Time-based codes require documentation of the actual time spent providing the service.