Arthroscopic shoulder surgery to cut and remove adhesions restricting joint motion, with or without manipulation of the shoulder

Verified May 8, 2026 · 6 sources ↓

Medicare: $553.45
Total RVUs: 16.57
Global, days: 90
Region: Shoulder

Drawn from CMSMedicare.govKzanowHealthcareinspiredllcAAPC

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Named diagnosis — adhesive capsulitis, frozen shoulder, or capsular contracture — with ICD-10 code to match
Documentation of failed conservative treatment (physical therapy, injections, or closed manipulation) prior to surgery
Operative note specifying extent of adhesion lysis and capsular structures released, not just 'standard arthroscopic approach'
Notation of whether intraoperative manipulation was performed and range of motion achieved post-release
Separate diagnosis code for any concurrent pathology if billing 29825 alongside other shoulder arthroscopy codes

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 50 Bilateral procedure 51 Multiple procedures 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 29825 covers arthroscopic lysis and resection of adhesions in the shoulder, with or without intraoperative manipulation. It is the go-to code for surgical treatment of adhesive capsulitis (frozen shoulder) when conservative measures have failed and the pathology requires direct arthroscopic release rather than a closed manipulation alone. The surgeon introduces an arthroscope and accessory instruments to divide and excise the restricting adhesions throughout the joint capsule, restoring range of motion under direct visualization.

This code carries a 90-day global period. All routine follow-up visits, wound checks, and manipulation-related care through day 90 are included. Add-on code 29826 (subacromial decompression) is billable with 29825 when performed at the same session, since CPT guidelines explicitly list 29825 as a valid primary code for 29826. For Medicare, 29825 and 29827 (rotator cuff repair) are bundled under NCCI payment rules, even though AAOS Global Service Data treats them as exclusive and separately reportable procedures — know which payer's rules govern before appending modifier 59.

Document adhesive capsulitis or a specific capsular pathology as the primary diagnosis driving surgical necessity. Vague operative notes citing only 'restricted shoulder motion' without a named diagnosis or failed conservative treatment history are the most common triggers for medical necessity denials on this code.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	7.6
Practice expense RVU	7.45
Malpractice RVU	1.52
Total RVU	16.57
Medicare national rate	$553.45
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	$553.45
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 29825 get rejected.

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

Medical necessity denial when operative note lacks documented failure of conservative treatment
NCCI bundling denial when 29825 is billed with 29827 for Medicare without understanding payer-specific edit rules
Diagnosis-procedure mismatch when a non-capsular ICD-10 code is paired with lysis of adhesions
Insufficient documentation of the adhesion extent and structures involved, triggering audit-related downcoding or denial
Missing laterality modifier (LT or RT) causing claim suspension or rejection at Medicare Administrative Contractors

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Can 29825 and 29827 be billed together?

Under CPT and AAOS Global Service Data rules, yes — they describe distinct procedures with separate indications. Under Medicare NCCI payment rules, they are bundled. If both are genuinely performed for separate conditions, append modifier 59 to 29825 when billing Medicare, and ensure each procedure has its own supporting diagnosis code.

02Can 29826 be billed with 29825?

Yes. CPT guidelines explicitly list 29825 as a valid primary code for add-on code 29826 (subacromial decompression with partial acromioplasty). Bill 29826 in addition to 29825 when subacromial decompression is performed in the same session.

03Does 29825 cover a closed manipulation under anesthesia (MUA) alone?

No. 29825 is an arthroscopic surgical code. Closed MUA without arthroscopy is reported with 23700. If the surgeon performs both arthroscopic lysis and manipulation, 29825 covers the combined service — do not stack 23700 on top.

04What is the global period for 29825?

90 days. Routine post-op visits, wound care, and range-of-motion checks within that window are included. Use modifier 24 for unrelated E/M visits and modifier 79 for unrelated procedures during the global period.

05Which ICD-10 codes most commonly support 29825?

M75.0x (adhesive capsulitis of shoulder) is the primary driver. Secondary capsular contracture or post-surgical stiffness diagnoses can also support the code, but must be documented as distinct from any concurrent rotator cuff or labral pathology if billing multiple procedures.

06Is laterality required when billing 29825?

Yes. Append LT or RT to identify the operative shoulder. Missing laterality is a common cause of claim suspension at Medicare Administrative Contractors and many commercial payers.

07When is modifier 22 appropriate with 29825?

When the lysis required substantially greater work than typical — for example, dense pan-capsular adhesions requiring prolonged operative time with documented complexity. The operative note must describe why the case exceeded the norm, and a cover letter with the claim strengthens the case. Expect scrutiny and possible audit.

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 capsular structures released, whether manipulation was performed, post-release range of motion measurements, and the named diagnosis (adhesive capsulitis, capsular contracture) directly from dictation. This prevents the two most common denial triggers: vague operative notes that omit which structures were lysed, and missing documentation of failed prior conservative treatment that payers require to establish medical necessity.

See how Mira captures CPT 29825 documentation