Arthroscopic surgical removal of part of the synovial lining of the shoulder joint (partial synovectomy).

Verified May 8, 2026 · 7 sources ↓

Medicare: $501.68
Total RVUs: 15.02
Global, days: 90
Region: Shoulder

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Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Confirm diagnosis driving the synovectomy — document the nature and duration of synovitis or inflammatory condition by name.
Specify laterality (left, right) in the operative note and on the claim.
Describe the extent of synovium excised and the compartment(s) entered — 'partial' must be supported by the note; total removal changes the code.
Record all instruments used and portals created to establish arthroscopic approach.
If osteoarthritis is a supporting diagnosis, document type (primary, secondary, post-traumatic) and anatomic location per ICD-10 specificity requirements.
For same-session procedures, document each procedure separately with distinct clinical rationale to support separate billing where NCCI allows it.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 51 Multiple procedures 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

29820 covers a shoulder arthroscopy in which the surgeon excises a portion of the inflamed synovial membrane — the tissue lining the joint capsule — using arthroscopic instruments. The indication is typically chronic synovitis causing pain and restricted motion that has not responded to conservative treatment. Because only part of the synovium is removed, this is coded as a partial synovectomy; total synovectomy is a different code.

This code carries a 90-day global period. All routine post-op care, dressing changes, and visits related to the shoulder through day 90 are bundled. Anything unrelated billed in that window needs modifier 24 or 25 on the E/M. The procedure is performed by orthopedic surgeons and sports medicine physicians, and is payable in both HOPD and ASC settings — see the Site of Service comparison table for payment figures.

Key bundling rule: 29820 is a Column 2 code under NCCI when 29827 (arthroscopic rotator cuff repair) is billed on the same shoulder in the same session. Modifier 59 does not override that edit — the partial synovectomy is considered integral to the more comprehensive procedure. If both procedures are genuinely performed on opposite shoulders, append LT and RT to distinguish laterality.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	7.03
Practice expense RVU	6.64
Malpractice RVU	1.35
Total RVU	15.02
Medicare national rate	$501.68
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$501.68
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI A2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 29820 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

29820 bundled into 29827 (rotator cuff repair) when both are billed for the same shoulder on the same date — modifier 59 does not override this NCCI edit.
Insufficient documentation of synovitis or inflammatory condition to support medical necessity for synovectomy.
Missing or conflicting laterality: claim shows LT but operative note documents right shoulder, or laterality is absent entirely.
ICD-10 diagnosis code too unspecified — payers require osteoarthritis type and laterality; M19.919 alone draws scrutiny.
Post-op E/M billed without modifier 24 during the 90-day global period, triggering automatic denial.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Can 29820 be billed with 29827 (rotator cuff repair) on the same shoulder the same day?

No. NCCI places 29820 as a Column 2 code to 29827. The partial synovectomy is considered integral to the rotator cuff repair. Modifier 59 does not override this edit. If the procedures are performed on opposite shoulders, use LT and RT to distinguish them — not modifier 59.

02Can 29820 be billed with 29828 (biceps tenodesis)?

No. CPT instructs that 29828 should not be reported in conjunction with 29820. If biceps tenodesis and synovectomy are both performed arthroscopically in the same shoulder session, report 29828 only.

03What modifier applies when 29820 is performed on the opposite shoulder from a procedure billed the same day?

Append LT to the left-side claim line and RT to the right-side claim line. That correctly identifies separate anatomic sites. Do not use modifier 59 to distinguish bilateral shoulder procedures — RT and LT are the correct laterality modifiers.

04What is the global period for 29820, and what does it include?

29820 carries a 90-day global period. That covers the day-before pre-op visit, the procedure itself, and all routine post-op care related to the shoulder through day 90. Unrelated E/M services in that window need modifier 24; a separate significant E/M on the day of surgery needs modifier 25.

05Does fluoroscopy billed during the arthroscopy get paid separately?

No. Per NCCI policy, fluoroscopy performed during an arthroscopic procedure is integral to the procedure. Bill only the arthroscopy code; separate fluoroscopy codes will deny.

06What ICD-10 codes are typically used with 29820?

Common diagnoses include M65.x (synovitis and tenosynovitis with specificity for laterality), M06.x (rheumatoid arthritis), and M75.x (shoulder lesions). For osteoarthritis as a supporting diagnosis, document type and laterality — unspecified codes like M19.919 invite additional documentation requests from payers.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the specific compartment(s) entered, the description of synovial tissue appearance (hypertrophied, inflamed, friable), the extent of resection, and confirmed laterality directly from the surgeon's dictation. That prevents the two most common audit flags for 29820: an operative note that says 'synovectomy performed' without describing extent (which auditors flag as insufficient to distinguish partial from total), and a missing laterality field that triggers claim rejection before clinical review even begins.

See how Mira captures CPT 29820 documentation