Arthroscopy · Knee

Arthroscopically aided treatment of an intercondylar spine or tibial tuberosity fracture of the knee, without internal or external fixation — arthroscopy included in the code.

Verified May 8, 2026 · 6 sources ↓

Medicare: $593.53
Total RVUs: 17.77
Global, days: 90
Region: Knee

Drawn from CMSPriorityhealthAAOSAoassn

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify laterality (right, left, or bilateral) in both the operative note and on the claim
Confirm fracture type and location: intercondylar spine, tibial tuberosity, or both
Document whether manipulation was performed during the arthroscopic procedure
State explicitly that no internal or external fixation devices were used
Record the arthroscopic findings and all compartments visualized
Note medical necessity for the procedure, including prior imaging and clinical presentation

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 52 Reduced services 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 29850 covers arthroscopically assisted management of intercondylar spine and/or tuberosity fractures of the proximal tibia, performed without internal or external fixation. Manipulation may or may not be performed. The arthroscopy itself is bundled into this code — do not separately bill a diagnostic arthroscopy (29870) alongside it.

The 90-day global period means the surgery date, any same-day preoperative E/M, and all routine postoperative visits through day 90 are folded into one payment. Unrelated E/M visits in that window require modifier 24. A staged or new injury procedure within the global requires modifier 79; an unplanned return to the OR for a related complication requires modifier 78.

If the arthroscopic procedure cannot be completed and is converted to an open approach, bill only the open procedure code — neither 29850 nor a diagnostic arthroscopy code is reportable alongside the open code. Laterality must be documented and reported with LT or RT on every claim.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.06
Practice expense RVU	8
Malpractice RVU	1.71
Total RVU	17.77
Medicare national rate	$593.53
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	$593.53
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 29850 get rejected.

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

Missing or unspecified laterality on the claim — payers require LT or RT
Separate billing of diagnostic arthroscopy 29870, which is bundled into 29850
ICD-10 diagnosis code not coded to the highest specificity for fracture site and laterality
Claim submitted without prior authorization when payer clinical criteria require it
Open procedure performed after arthroscopic attempt without switching to the correct open code

Frequently asked questions

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

01Is the diagnostic arthroscopy billable separately with 29850?

No. Diagnostic arthroscopy (29870) is always bundled into surgical arthroscopy codes, including 29850. Billing both triggers an NCCI edit and will result in denial of 29870.

02What happens if the arthroscopic approach is converted to open surgery?

Bill only the open procedure code. Per CMS NCCI policy, neither 29850 nor a diagnostic arthroscopy code may be reported alongside the open code when a conversion occurs.

03Does 29850 require modifier LT or RT?

Yes. Payer billing policies — including Priority Health's knee arthroscopy policy — require laterality on every claim. Missing laterality is a top denial trigger for this code.

04When does modifier 22 apply to 29850?

Use modifier 22 when the procedure required substantially more work than typical — for example, a severely comminuted fracture requiring prolonged arthroscopic reduction. Document the increased time and complexity in the operative note; without that documentation the modifier will be rejected.

05Can 29851 and 29850 be billed together for the same knee?

No. 29850 is without fixation; 29851 covers the same fracture treated with fixation. They are mutually exclusive codes for the same anatomic scenario — bill the one that matches what was actually done.

06What ICD-10 codes typically support 29850?

Fractures of the intercondylar eminence or tibial spine map to the S82 category. Code to the highest specificity: laterality, fracture type (displaced vs. nondisplaced), and encounter type (initial vs. subsequent) are all required for clean claim submission.

07How does the 90-day global period affect post-op billing?

All routine follow-up visits through day 90 are included in the 29850 payment. Append modifier 24 to unrelated E/M visits during the global and modifier 79 for unrelated procedures. An unplanned return to the OR for a related complication takes modifier 78.

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 fracture location (intercondylar spine vs. tuberosity), whether manipulation was performed, explicit confirmation that no fixation was used, and laterality — all from surgeon dictation. That prevents the two most common 29850 denials: unspecified laterality and missing fixation-status documentation, which payers use to downcode or redirect to a fixation code.

See how Mira captures CPT 29850 documentation