Arthroscopic elbow surgery involving partial removal of the synovial lining (synovectomy) through small portal incisions without open exposure of the joint.

Verified May 8, 2026 · 6 sources ↓

Medicare: $486.99
Total RVUs: 14.58
Global, days: 90
Region: Elbow

Drawn from CMSAAPCUhcproviderCgsmedicare

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Operative note must specify extent of synovectomy — 'partial' must be documented explicitly; do not use generic language like 'synovectomy performed'
Identify the specific compartments or regions of the elbow where synovial tissue was excised (e.g., anterior, posterior, radiocapitellar)
Document portal placement sites and arthroscope findings before and after resection
Include preoperative diagnosis with supporting clinical history — e.g., inflammatory arthritis, synovitis on MRI, failed conservative treatment
If additional procedures performed at the same session (e.g., loose body removal, debridement), each must be independently documented with distinct findings and medical necessity
Anesthesia type and patient positioning should be noted to support the operative setting billed

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 58 Staged or related 59 Distinct service 62 Co-surgeons LT Left side RT Right side 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 29835 describes a surgical elbow arthroscopy in which the surgeon partially excises the synovial membrane — the tissue lining the joint capsule between the bony surfaces. This is distinct from a complete synovectomy (29836) and from simple diagnostic arthroscopy (29830). The code is used when inflammatory or reactive synovial tissue is causing symptoms but a full synovectomy is not warranted. Partial means the surgeon removes a portion, not the entire lining.

The 90-day global period covers the operative day, the day-before visit if applicable, and all routine post-operative management through day 90. Anything unrelated to the elbow synovectomy billed during that window requires modifier 24 (E/M) or 79 (unrelated procedure). Arthrocentesis of the same elbow joint on the same date is not separately reportable per NCCI policy — it bundles into the arthroscopic procedure. Fluoroscopy used intraoperatively is also integral and cannot be billed separately.

Site of service matters for reimbursement. The HOPD and ASC facility payments differ substantially; see the Site of Service comparison table on this page. When billing the same elbow joint on the same encounter with additional surgical arthroscopy codes, check NCCI procedure-to-procedure edits carefully — elbow arthroscopy codes in the 29834–29838 range are frequently paired against each other, and modifier 59 or an X-modifier may be required only where the edit allows a modifier (indicator 1). Modifier 51 applies when 29835 is a secondary procedure on the same day.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	6.45
Practice expense RVU	6.77
Malpractice RVU	1.36
Total RVU	14.58
Medicare national rate	$486.99
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	$486.99
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 29835 get rejected.

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

Medical necessity not established — no documentation of failed conservative management or imaging confirming synovitis prior to surgery
Operative note uses vague language ('synovectomy done') without specifying partial vs. complete scope, triggering a downcode query or denial
Unbundling error — billing 20605 or 20606 arthrocentesis of the same elbow joint on the same date, which bundles into 29835 under NCCI policy
Global period conflict — post-op E/M visit billed without modifier 24 during the 90-day global window
Site of service mismatch between the claim and facility records, especially when the case moves from ASC to HOPD or vice versa
Missing or mismatched laterality — payers increasingly require LT or RT on elbow arthroscopy claims; omitting it causes automated rejection

Frequently asked questions

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

01What is the difference between CPT 29835 and 29836?

29835 is a partial synovectomy — only a portion of the synovial lining is removed. 29836 is a complete synovectomy, meaning the entire lining is excised. Your operative note must explicitly support the extent billed; auditors will downcode 29836 to 29835 if documentation is ambiguous.

02Can I bill 29835 with 29837 or 29838 on the same elbow, same day?

Potentially, but NCCI procedure-to-procedure edits apply across the 29834–29838 range. Check the modifier indicator for the specific pair. Where the indicator is 1, modifier 59 or XS can bypass the edit if the procedures were distinct and separately documented. Where the indicator is 0, you cannot bill both regardless of documentation.

03Can I bill arthrocentesis (20605/20606) of the same elbow on the same day as 29835?

No. Per CMS NCCI policy, arthrocentesis of the same joint as an arthroscopic procedure is not separately reportable on the same date. If arthrocentesis was performed on a different joint at the same encounter, it may be billed separately.

04Is fluoroscopy separately billable when used during 29835?

No. Fluoroscopy used intraoperatively during any arthroscopic procedure is considered integral to the procedure under NCCI policy and cannot be billed separately.

05What modifier applies if I perform 29835 on a patient who had elbow surgery with me 6 weeks ago for an unrelated problem?

Use modifier 79 — unrelated procedure during the global period. Modifier 78 is for a return to the OR for a complication or related procedure. Do not invert them; incorrect use of 78 vs. 79 is an audit trigger.

06Do I need LT or RT on 29835 claims?

Most commercial payers and many Medicare contractors require laterality modifiers on elbow arthroscopy claims. Omitting LT or RT is a common automated rejection trigger. Bill the appropriate modifier on every claim.

07How does the 90-day global period affect post-op elbow therapy referrals and follow-up E/M visits?

Routine post-op visits during the 90-day global are included in the 29835 payment — do not bill them separately. If a follow-up E/M addresses a problem unrelated to the synovectomy, append modifier 24 and document the unrelated condition clearly. Physical therapy referrals are not bundled and are billed by the therapy provider separately.

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 compartments accessed, the extent of synovial resection (partial vs. complete), arthroscopic findings at each portal, and any ancillary procedures performed — all from dictation. That specificity prevents the most common 29835 denial: an operative note that documents 'synovectomy' without confirming partial extent or anatomic distribution, which auditors flag as insufficient to support the code over a less-specific arthroscopy service.

See how Mira captures CPT 29835 documentation