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29875

Arthroscopy, knee, surgical; synovectomy, limited

Orthopedics Arthroscopy 23.20 Total RVUs
Quick Reference
For surgical knee arthroscopy with limited synovectomy

Relative Value Units (RVUs)

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Work RVU
10.00
Physician effort
PE RVU
12.20
Practice expense
MP RVU
1.00
Malpractice
Total RVU
23.20
Combined value
Dollar reimbursement rates vary by locality and payer. RVUs shown for relative comparison only.
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Clinical Information

When to Use

For surgical knee arthroscopy with limited synovectomy

Time Requirement
45-75 minutes typical operative time

Common Scenarios

Limited synovectomy for synovitis
Partial synovial resection
Synovectomy for inflammatory arthritis
Limited synovial debridement
Partial synovectomy

Documentation Requirements

  • Indication for synovectomy
  • Extent of synovectomy
  • Compartments involved
  • Synovial pathology
  • Any complications

Coding Guidelines

Common Modifiers

50 Bilateral procedure when both knees performed same session
51 Multiple procedures performed same session
22 Increased procedural services for extensive synovectomy
LT Left side procedure
RT Right side procedure

Bundling Rules

  • Includes surgical arthroscopy
  • Includes limited synovectomy
  • Diagnostic arthroscopy bundled when performed same session
  • Major synovectomy coded separately
  • Debridement coded separately

Exclusions

  • 29870 (arthroscopy, knee, diagnostic)
  • 29876 (arthroscopy, knee, surgical; synovectomy, major)
  • 29875 (arthroscopy, knee, surgical; synovectomy, limited)
  • 29877 (arthroscopy, knee, surgical; debridement)

Coding Notes

Limited synovectomy only
Document extent of synovectomy
Global period is 90 days
Document compartments involved

Clinical scenarios

Limited synovectomy for synovitis
Limited synovectomy for synovitis
When to use:For surgical knee arthroscopy with limited synovectomy
  • Indication for synovectomy
  • Extent of synovectomy
  • Compartments involved
Partial synovial resection
Partial synovial resection
When to use:For surgical knee arthroscopy with limited synovectomy
  • Indication for synovectomy
  • Extent of synovectomy
  • Compartments involved
Synovectomy for inflammatory arthritis
Synovectomy for inflammatory arthritis
When to use:For surgical knee arthroscopy with limited synovectomy
  • Indication for synovectomy
  • Extent of synovectomy
  • Compartments involved

Who are you?

Code Details

Code 29875
Category Orthopedics
Subcategory Arthroscopy
Total RVUs 23.20

Medicare Pricing

PFS
2025 National Rate
$494.25
Facility
$494.25
Non-Facility
$494.25
RVU Breakdown
Work RVU:6.45PE RVU:7.54MP RVU:1.29Total RVU:15.28CF:$32.3465Global Days:090
OPPS Details
APC:5113Status:J1Copayment:
Physician Fee Schedule: Medicare pays physicians based on Relative Value Units (RVUs) multiplied by a conversion factor.

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Frequently Asked Questions

What is CPT code 29875?

CPT 29875 is the billing code for "Arthroscopy, knee, surgical; synovectomy, limited". For surgical knee arthroscopy with limited synovectomy

How much does Medicare pay for CPT 29875?

Medicare pays approximately $494.25 for CPT 29875 (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.

What are the RVUs for CPT 29875?

CPT 29875 has a total RVU of 23.20, broken down as: Work RVU 10.00, Practice Expense RVU 12.20, and Malpractice RVU 1.00. RVUs (Relative Value Units) determine Medicare reimbursement rates.

What documentation is required for CPT 29875?

Key documentation requirements for CPT 29875 include: Indication for synovectomy; Extent of synovectomy; Compartments involved; Synovial pathology. Missing or incomplete documentation is a leading cause of claim denials for this code.

Can CPT 29875 be billed with other codes?

Bundling considerations for CPT 29875: Includes surgical arthroscopy. Includes limited synovectomy Use an NCCI bundling checker to verify specific code combinations before billing.

What modifiers are commonly used with CPT 29875?

Common modifiers for CPT 29875 include: 50 (Bilateral procedure when both knees performed same session), 51 (Multiple procedures performed same session), 22 (Increased procedural services for extensive synovectomy). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

What is the time requirement for CPT 29875?

The typical time requirement for CPT 29875 is 45-75 minutes typical operative time. Time-based codes require documentation of the actual time spent providing the service.

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