Arthroscopic shoulder surgery involving tenodesis of the long head of the biceps tendon — the tendon is detached from its origin and reanchored to a new fixation point, performed entirely through arthroscopic portals.

Verified May 8, 2026 · 7 sources ↓

Medicare: $843.71
Total RVUs: 25.26
Global, days: 90
Region: Shoulder

Drawn from CMSMedicaidAAOSAbosHealthcareinspiredllc

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Confirm arthroscopic approach is documented — open tenodesis is not 29828
Specify fixation method used (suture anchor, interference screw, soft-tissue, subpectoral, etc.)
Document the indication: SLAP pathology, biceps instability, tendinopathy, partial tear, or failed conservative treatment
Record findings at the biceps origin and bicipital groove, including the condition of the tendon at detachment
Note all concomitant procedures performed in the same session and which compartment/area each addressed — required to support separate billing of 29823
Include pre-op imaging (MRI or ultrasound) confirming biceps pathology to support medical necessity

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 57 Decision for surgery 59 Distinct service 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 29828 describes an arthroscopic biceps tenodesis of the shoulder. The surgeon detaches the long head of the biceps from its superior labral attachment (or tenotomizes it at the bicipital groove) and reanchors it to the proximal humerus or soft tissue using suture anchors, interference screws, or tendon-to-bone fixation — all through arthroscopic access. This is the definitive code when tenodesis is performed; if the surgeon simply cuts the tendon without reanchoring, that maps to tenotomy coding, not 29828.

The code carries a 90-day global period. All routine post-op visits, dressing changes, and E&M services related to the tenodesis are bundled through day 90. A same-day E&M for the decision to proceed with surgery requires modifier 57; unrelated post-op procedures need modifier 79; a related unplanned return to the OR within the global uses modifier 78.

NCCI policy allows 29828 to be reported separately with 29823 (extensive debridement) only when the debridement is performed in a different area of the same shoulder. Limited debridement (29822) is always bundled into 29828 on the ipsilateral shoulder — no modifier overrides that edit on the same side. 29824 (Mumford), 29826 (subacromial decompression), and 29827 (rotator cuff repair) are commonly billed with 29828 in the same session; apply modifier 51 on the secondary procedure(s) when required by payer contract.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	12.83
Practice expense RVU	9.85
Malpractice RVU	2.58
Total RVU	25.26
Medicare national rate	$843.71
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	$843.71
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI G2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 29828 get rejected.

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

Medical necessity not established — no imaging or failed conservative care documented before surgery
29822 (limited debridement) billed separately on the ipsilateral shoulder — NCCI bundles it into 29828 without override
29823 (extensive debridement) billed same-shoulder without documentation that debridement was in a distinct area from the tenodesis
Modifier 59 used to bypass a bundling edit when contralateral-shoulder documentation is absent
Operative note describes tenotomy only (tendon cut, not reanchored) — 29828 requires fixation to a new site
Prior authorization not obtained — common requirement for this code among commercial payers

Frequently asked questions

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

01Can 29828 and 29827 (rotator cuff repair) be billed together?

Yes. 29827 and 29828 are separately payable in the same session. List the higher-value code first and apply modifier 51 to the secondary code per payer requirements. Both procedures must be documented with distinct operative findings justifying each.

02Is limited debridement (29822) separately billable when performed in the same shoulder as 29828?

No. NCCI policy bundles 29822 into all shoulder arthroscopy procedures on the ipsilateral side, regardless of where in the shoulder the debridement was performed. No modifier overrides this edit on the same shoulder.

03When can 29823 (extensive debridement) be billed with 29828?

Only when the extensive debridement is performed in a different area of the same shoulder than the biceps tenodesis. The operative note must clearly document the separate anatomic location of the debridement. This is one of three specific NCCI exceptions that permit 29823 to be reported separately with another shoulder arthroscopy code.

04What modifier is needed if the surgeon performs a same-day E&M to decide whether to proceed with biceps tenodesis?

Modifier 57. The decision-for-surgery E&M on the same date as a major surgery (90-day global) is separately reportable with modifier 57 appended to the E&M code. Without it, the E&M will deny as bundled into the global package.

05Does 29828 require prior authorization?

Many commercial payers require prior authorization for 29828. Requirements vary by payer and plan. Confirm authorization before scheduling — retro-auth approvals are routinely denied by plans that list this code as prior-auth required.

06What is the correct code if the surgeon performs tenotomy only, without reanchoring the biceps tendon?

29828 requires tenodesis — detachment and fixation to a new site. If the surgeon cuts the tendon without reattachment, do not use 29828. Report the appropriate tenotomy code based on the approach and document why tenodesis was not performed.

07Can 29828 be billed bilaterally?

Bilateral biceps tenodesis in a single session is extremely rare clinically, but if performed, append modifier 50 and verify payer-specific bilateral payment rules. Most payers reimburse the second side at 50% of the allowed amount.

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 fixation method, anchor type, anatomic site of reattachment, arthroscopic portal documentation, and the condition of the biceps tendon at detachment from the dictated operative note. It also flags when the note describes tenotomy without reanchoring — which doesn't support 29828 — and tags concomitant procedures by shoulder compartment to support separate billing of 29823 where NCCI rules permit.

See how Mira captures CPT 29828 documentation