Arthroscopic shoulder surgery to decompress the subacromial space, including partial reshaping of the acromion and release of the coracoacromial ligament when performed. Add-on code — always listed in addition to a primary shoulder arthroscopy code.

Verified May 8, 2026 · 10 sources ↓

Medicare: $147.63
Total RVUs: 4.42
Global, days
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 10 cited references ↓

Explicit documentation of bony work on the acromion — e.g., 'acromioplasty performed, acromion reshaped from type 3 to type 1'
Reference to a bony instrument (e.g., burr, shaver on bone) in the body of the operative note, not just the procedure title
Documentation of coracoacromial ligament release if performed, noted separately within the operative report
Identification of the primary shoulder arthroscopy code being performed, since 29826 is invalid without a host procedure from 29806–29825, 29827, or 29828
Clear distinction between subacromial bursectomy (debridement) and partial acromioplasty — documenting only bursa removal does not support 29826
Laterality documented (left or right shoulder) to support LT or RT modifier if required by payer

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 10 cited references ↓

CPT 29826 is an add-on code (+29826) for arthroscopic subacromial decompression with partial acromioplasty and coracoacromial ligament release. It must be reported alongside a primary shoulder arthroscopy code from the 29806–29825, 29827, or 29828 range — never as a standalone code. The procedure requires actual bony work on the acromion (acromioplasty); soft-tissue bursectomy alone does not meet the definition. Documentation needs to reflect that bone was resected — typically converting a type 2 or type 3 acromion to a type 1 — and many payers now specifically require reference to a bony instrument in the operative note body.

Billing 29826 carries a known payer-specific denial risk. AIM Specialty Health guidelines have classified subacromial decompression as not medically necessary for all indications, driving denials when 29826 is billed with 29824 or 29827. No NCCI procedure-to-procedure edit bundles these pairs, and CMS removed language from the NCCI Policy Manual in 2020 that had treated the shoulder as a single anatomic structure — both points are central to a successful appeal. AAOS, ASES, AANA, and AOSSM have formally contested AIM's guidelines.

For Medicare, 29826 is not separately reimbursed as an add-on — it bundles into the primary procedure payment. For commercial and workers' comp payers, reimbursement varies: some workers' comp carriers still treat 29826 as a full-value standalone code. Coders attempting to work around bundling by fragmenting the bursa work into 29822 or 29823 and upgrading those codes violate NCCI policy manual guidance against unbundling component parts to increase payment.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	2.93
Practice expense RVU	0.91
Malpractice RVU	0.58
Total RVU	4.42
Medicare national rate	$147.63
Global period	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	$147.63

Common denial reasons

The recurring reasons claims for CPT 29826 get rejected.

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

Payer medical necessity policy (notably AIM Specialty Health) classifies subacromial decompression as not medically necessary for all indications, triggering blanket denials
Operative note documents only subacromial bursectomy without bony acromioplasty — soft-tissue work alone does not satisfy the code definition
Medicare bundles 29826 into the primary procedure and does not pay it separately as an add-on
Some carriers incorrectly package 29826 into a rotator cuff repair (29827) even though no NCCI PTP edit requires this bundling
Code billed without a valid primary shoulder arthroscopy code from the approved conjunct code list, making the add-on unprocessable

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 10 cited references ↓

01Can 29826 be billed alone without another shoulder arthroscopy code?

No. 29826 is an add-on code and is only valid when reported with a primary shoulder arthroscopy procedure from 29806–29825, 29827, or 29828. Submitting it standalone will result in rejection.

02Does Medicare pay 29826 separately?

No. For Medicare, 29826 is an add-on code that does not carry separate reimbursement — it bundles into the primary procedure payment. Some workers' comp and commercial payers still reimburse it as a full-value code, so verify each payer's policy.

03Is a subacromial bursectomy alone enough to bill 29826?

No. The code requires partial acromioplasty — actual bone work on the acromion. If only the bursa was excised, report debridement (29822 or 29823) instead. Billing 29826 for soft-tissue-only work is a documentation compliance risk.

04Why is 29826 being denied when billed with 29824 or 29827 if there's no NCCI edit?

AIM Specialty Health guidelines, used by several Blue Cross plans and commercial payers, classify subacromial decompression as not medically necessary for all indications. There is no NCCI PTP edit bundling these pairs, so the denial is a medical necessity determination, not a coding edit. Appeals should cite the absence of NCCI edits, the CPT add-on code designation, and the AAOS Global Service Data guidance that 29824, 29826, and 29827 are separately reportable.

05What documentation do payers require to support the bony work in 29826?

Most payers want the operative note body — not just the procedure title — to reference a bony tool and describe the result of the acromioplasty, such as conversion from a type 2 or type 3 acromion to a type 1. Phrases like 'standard acromioplasty performed' without instrument reference or outcome description are the most common documentation gaps cited on audit.

06Can a coder substitute 29823 for 29826 when 29826 is denied to capture bursa work?

Only if 29823's requirements (extensive debridement of 3 or more discrete structures) are independently met and documented. You cannot move bursa work from 29826 into 29823 and upgrade the debridement code solely to circumvent bundling — the NCCI Policy Manual explicitly prohibits fragmenting a service into component parts to increase payment.

07Does modifier 59 override denials of 29826 billed with 29827?

Modifier 59 addresses distinct procedural services, not medical necessity denials. Since there is no NCCI PTP edit between 29826 and 29827, modifier 59 is not the solution. Appeals for medical necessity denials should focus on clinical documentation and payer policy arguments, not modifier attachment.

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 acromion type pre- and post-resection, the specific bony instrument used, and whether the coracoacromial ligament was released — all from dictation. That detail goes directly into the operative note body, not just the procedure title, which is the documentation gap most commonly cited in 29826 denials. When the scribe logs the primary arthroscopy code performed in the same session, it also flags if 29826 is being dictated without a valid host code.

See how Mira captures CPT 29826 documentation