Arthroscopy · Knee

29855

Arthroscopically aided repair of a unicondylar tibial plateau fracture, with internal fixation when performed; arthroscopy included in the procedure.

Verified May 8, 2026 · 6 sources ↓

Medicare
$729.81
Total RVUs
21.85
Global, days
90
Region
Knee
Drawn from CMSAAPCKzanowAbosAAOS

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

  • Specify which condyle is fractured (medial or lateral) — unicondylar vs. bicondylar determines 29855 vs. 29856
  • Describe fracture visualization under arthroscopy, including articular surface assessment and any associated intra-articular pathology
  • Document reduction technique and confirm anatomic or near-anatomic alignment achieved arthroscopically
  • Record fixation construct used (screw count, plate type, size) if internal fixation was performed
  • Note pre-op imaging (X-ray, CT) confirming unicondylar involvement to support code selection on audit
  • Dictate the arthroscopic findings explicitly — do not state 'standard approach'; name portals used and compartments inspected

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 29855 covers arthroscopic-assisted treatment of a proximal tibial (plateau) fracture limited to one condyle — medial or lateral. Internal fixation (screws, plates) is included in the code when performed; you do not report it separately. The arthroscopy itself is also bundled — do not stack a separate knee arthroscopy code.

The unicondylar designation is the critical selection point. If both condyles are involved, step up to 29856. If the fracture involves the intercondylar spine or tibial tuberosity rather than the plateau surface, use 29851. Calcium phosphate subchondral injection without a true plateau fracture reduction is not 29855 — that work maps to Category III code 0707T per AMA CPT Assistant guidance.

29855 carries a 90-day global period. All routine post-op visits, wound checks, and stitch removals through day 90 are bundled. Bill an E/M in that window only for a new or unrelated problem (modifier 24) or a separately identifiable service on the day of surgery (modifier 25 on the E/M). Use modifier 57 on a same-day or day-before E/M if that visit was the decision-for-surgery encounter.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU10.49
Practice expense RVU9.2
Malpractice RVU2.16
Total RVU21.85
Medicare national rate$729.81
Global period90 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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$729.81
HOPD (APC 5114)
Hospital outpatient department
$7,413.38
ASC (PI J8)
Ambulatory surgical center (freestanding)
$5,132.37

Common denial reasons

The recurring reasons claims for CPT 29855 get rejected.

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

  • Code billed as 29855 when operative note describes bicondylar involvement — should be 29856
  • Separate arthroscopy code (e.g., 29870–29999) billed in addition to 29855 — arthroscopy is bundled and will be denied as duplicate
  • Calcium phosphate subchondral injection reported as 29855 without documented true plateau fracture reduction — maps to 0707T per AMA guidance
  • Routine post-op E/M visits billed without modifier 24 during the 90-day global period
  • Missing pre-operative imaging documentation supporting unicondylar fracture diagnosis, triggering medical necessity denial

Frequently asked questions

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

01What is the difference between 29855 and 29856?
29855 is for a unicondylar tibial plateau fracture — only one condyle (medial or lateral) is treated. 29856 covers bicondylar involvement. The condyle count in the operative note and pre-op imaging is the deciding factor; selecting the wrong code is a top audit trigger.
02Is the arthroscopy separately billable when reporting 29855?
No. Arthroscopy is bundled into 29855 by definition. Billing a standalone diagnostic or surgical arthroscopy code alongside 29855 will be denied as a duplicate service.
03Can I bill 29855 when the surgeon injects calcium phosphate into a subchondral defect?
Not if that is the entirety of the work. AMA CPT Assistant guidance (addressed in 2019 and January 2022) directs that subchondral calcium phosphate injection maps to Category III code 0707T, not 29855. 29855 requires actual fracture reduction and optional internal fixation of the plateau.
04What global period applies, and what does it cover?
29855 carries a 90-day global period. That bundles the surgery, the day-before visit, and all routine post-op care through day 90. Bill E/M during that window only for unrelated problems (modifier 24) or a separately identifiable same-day service (modifier 25). Use modifier 57 if the same-day or prior-day E/M was the decision-for-surgery visit.
05When is modifier 22 appropriate for 29855?
Use modifier 22 when the procedure required substantially greater work than typical — for example, severely comminuted articular fragments, obesity complicating positioning, or extensive intra-articular debris requiring additional time. The operative note must quantify why the work exceeded the norm; a vague 'difficult case' comment will not survive audit.
06How does 29855 differ from 29851?
29851 addresses intercondylar spine or tibial tuberosity fractures. 29855 is specific to the tibial plateau (condylar) surface. These are anatomically distinct fracture patterns — confirm on pre-op CT or MRI before selecting the code.
07Can 29855 be billed bilaterally?
Bilateral tibial plateau fractures treated arthroscopically in the same session are rare, but if it occurs, append modifier 50 and document bilateral findings and repair explicitly in the operative note. Expect payer scrutiny — submit supporting imaging with the claim.

Mira AI Scribe

Mira's AI scribe captures the condyle involved (medial vs. lateral), arthroscopic portal placement, fracture visualization and reduction technique, and fixation construct details directly from surgeon dictation. This prevents the most common 29855 audit flag: an operative note that fails to confirm unicondylar involvement, which auditors use to downcode or deny the claim outright.

See how Mira captures CPT 29855 documentation

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