Arthroscopy, shoulder, surgical; debridement, extensive

CPT 29823 is the billing code for "Arthroscopy, shoulder, surgical; debridement, extensive". For surgical shoulder arthroscopy with extensive debridement

Medicare pays approximately $587.74 for CPT 29823 (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 29823 has a total RVU of 31.05, broken down as: Work RVU 13.50, Practice Expense RVU 16.20, and Malpractice RVU 1.35. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 29823 include: Indication for extensive debridement; Location and extent of cartilage damage; Debridement technique; Grade of cartilage damage. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 29823: Includes surgical arthroscopy. Includes extensive debridement Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 29823 include: 50 (Bilateral procedure when both shoulders performed same session), 51 (Multiple procedures performed same session), 22 (Increased procedural services for extensive debridement). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 29823 is 60-90 minutes typical operative time. Time-based codes require documentation of the actual time spent providing the service.