Arthroscopic resection of the distal clavicle including its articular surface, performed at the acromioclavicular joint (the Mumford procedure).

Verified May 8, 2026 · 7 sources ↓

Medicare: $638.96
Total RVUs: 19.13
Global, days: 90
Region: Shoulder

Drawn from CMSKzanowAAOSAAPC

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Operative note must explicitly state 'resection of the distal clavicle' — co-planing, spur removal, or osteophyte debridement does not support this code
Identify the surgical approach and portal placement used to access the AC joint
Document the clinical indication: AC joint arthritis, osteolysis, or post-traumatic degenerative change with conservative treatment failure
If billing 29823 same-session, document the anatomic area of the debridement as distinct from the distal clavicle resection site
Confirm arthroscopic (not open) technique in the operative note; open resection maps to a different code family
Record findings at the AC joint including joint space assessment and condition of the distal clavicle articular surface

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 59 Distinct service LT Left side RT Right side 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 29824 describes an arthroscopic distal claviculectomy — surgical removal of the distal end of the clavicle including the articular surface — performed to address AC joint arthritis or osteolysis. This is the arthroscopic equivalent of the open Mumford procedure. The surgeon removes bone through arthroscopic portals rather than an open incision, decompressing the AC joint and eliminating painful bone-on-bone contact.

Documentation must confirm actual resection of the distal clavicle, not merely co-planing, spur removal, or osteophyte debridement. The AMA has clarified that no specific millimeter measurement is required, but the operative note must describe resection — not shaving or contouring. If the note only says 'co-planing of the AC joint,' the claim will not support 29824.

Non-Medicare payers may follow CPT guidelines permitting 29823 (extensive debridement) alongside 29824 with modifier 59 when performed in a distinct area. Under Medicare NCCI policy, 29822 (limited debridement) is always bundled into 29824. Extensive debridement (29823) is also bundled into 29824 under Medicare — unless it is performed in a different area of the same shoulder, in which case 29823 may be separately reported. The 90-day global period covers all routine post-op care; anything unrelated in that window requires modifier 24 or 25.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.76
Practice expense RVU	8.61
Malpractice RVU	1.76
Total RVU	19.13
Medicare national rate	$638.96
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	$638.96
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 29824 get rejected.

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

Operative note describes co-planing or spur removal rather than resection — payers downcode or deny 29824 outright
29823 billed same-session without supporting documentation showing debridement in a distinct anatomic area, triggering NCCI bundling denial under Medicare
Missing or insufficient conservative treatment history to support medical necessity for surgical resection
29822 billed alongside 29824 — limited debridement is always bundled into 29824 under NCCI and cannot be unbundled
Laterality not specified when billing bilateral or when LT/RT modifier is required by the payer

Frequently asked questions

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

01Does the operative note need to specify how many millimeters of clavicle were removed?

No. The AMA clarified that 29824 does not require a specific bone-excision measurement. The note must describe resection of the distal clavicle — not co-planing or spur removal — but no minimum millimeter threshold applies per current CPT guidance.

02Can 29823 be billed with 29824 on the same day?

Under Medicare NCCI rules, yes — but only if the extensive debridement is performed in a different anatomic area of the same shoulder than the distal clavicle resection. The operative note must clearly document that distinction. Non-Medicare payers may follow CPT guidelines, which are less restrictive; check individual payer policies.

03Can 29822 (limited debridement) be separately billed with 29824?

No. Under Medicare NCCI policy, limited debridement (29822) is always bundled into other shoulder arthroscopy procedures including 29824, even when performed in a different area of the same shoulder. It cannot be unbundled regardless of modifier use.

04What ICD-10 diagnoses typically support 29824?

M19.011 (primary osteoarthritis, right shoulder) and M19.012 (left shoulder) are the most common pairings. AC joint osteolysis (M89.X1-) and post-traumatic arthritis codes also support medical necessity. Confirm payer LCD requirements for conservative treatment documentation before submitting.

05Does co-planing of the AC joint support billing 29824?

No. Co-planing, contouring, or bone spur removal at the AC joint does not constitute distal clavicle resection. Per KZA guidance, 29824 requires explicit documentation that the surgeon performed a resection of the distal clavicle. Claims billed on co-planing language alone are audit targets.

06What modifiers are needed when 29824 is performed with rotator cuff repair (29827) on the same shoulder?

Modifier 51 applies when billing multiple procedures under non-Medicare payers. Medicare does not use modifier 51 for facility claims. Use LT or RT to confirm laterality. Both codes are independently reportable under NCCI — 29827 is one of the specific exceptions that allows concurrent reporting of 29823 if applicable.

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 surgeon's dictation of distal clavicle resection — distinguishing true bone excision from co-planing or spur removal — and flags when the note lacks explicit resection language before the claim is built. It also records the anatomic area of any concurrent debridement, preserving the documentation needed to support 29823 as a separately reportable service under NCCI exception rules when performed at a distinct shoulder site.

See how Mira captures CPT 29824 documentation