Arthroscopy, shoulder, surgical; with lysis and resection of adhesions

CPT 29825 is the billing code for "Arthroscopy, shoulder, surgical; with lysis and resection of adhesions". For surgical shoulder arthroscopy with lysis and resection of adhesions

Medicare pays approximately $582.56 for CPT 29825 (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 29825 has a total RVU of 26.45, broken down as: Work RVU 11.50, Practice Expense RVU 13.80, and Malpractice RVU 1.15. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 29825 include: Indication for lysis and resection of adhesions; Extent of adhesions; Location of adhesions; Release technique. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 29825: Includes surgical arthroscopy. Includes lysis and resection of adhesions Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 29825 include: 50 (Bilateral procedure when both shoulders performed same session), 51 (Multiple procedures performed same session), 22 (Increased procedural services for extensive lysis). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 29825 is 50-80 minutes typical operative time. Time-based codes require documentation of the actual time spent providing the service.