Arthroscopy · Hip

Arthroscopic hip surgery involving chondroplasty, abrasion arthroplasty, and/or partial labral resection to address damaged cartilage or labral pathology.

Verified May 8, 2026 · 7 sources ↓

Medicare: $759.87
Total RVUs: 22.75
Global, days: 90
Region: Hip

Drawn from CMSMdclarityAAPCMcgsAetna

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Specify which procedure(s) were performed: chondroplasty, abrasion arthroplasty, and/or labral resection — not just 'debridement'
Document failed conservative treatment (physical therapy, NSAIDs, intra-articular injections) prior to surgery
Include radiologic findings confirming pathology (e.g., cartilage damage, labral tear, FAI on MRI or X-ray)
Tönnis classification or equivalent grading of osteoarthritis documented in pre-op workup
If billing alongside FAI codes (29914/29915/29916), document the distinct surgical work supporting separate reporting of 29862
Operative note must name the specific arthroscopic findings and interventions — 'standard hip scope with debridement' is insufficient for audit

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 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 7 cited references ↓

29862 covers arthroscopic surgical intervention at the hip joint where the surgeon performs one or more of the following: shaving or smoothing damaged articular cartilage (chondroplasty), abrasion arthroplasty to stimulate healing at the cartilage surface, or resection (trimming/removal) of torn or degenerated labral tissue. It is not a repair code — if the labrum is sutured or reconstructed, that's 29916. The distinction matters: 29862 is debridement and resection; 29916 is repair and includes chondroplasty, synovectomy, and acetabuloplasty within its descriptor.

Payer scrutiny on this code is high. Aetna's clinical policy explicitly states that isolated hip arthroscopic debridement is considered experimental and unproven, and that debridement performed alongside FAI surgery (29914/29915/29916) is considered integral to those codes — meaning 29862 would not be separately reimbursable in that context. BCBS Florida applies similar restrictions tied to Tönnis classification, requiring documented conservative treatment failure and radiologically confirmed pathology before approving surgical hip arthroscopy.

The 90-day global period means all routine follow-up through day 90 is bundled. Separate billing within that window requires modifier 24 (unrelated E/M) or 79 (unrelated procedure). An unplanned return to the OR for a related issue in the global period uses modifier 78 — not 79.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	10.89
Practice expense RVU	9.69
Malpractice RVU	2.17
Total RVU	22.75
Medicare national rate	$759.87
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	$759.87
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI A2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 29862 get rejected.

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

Isolated debridement deemed experimental or not medically necessary per payer clinical policy (Aetna, BCBS)
Bundled into FAI surgery codes 29914/29915/29916 when performed in same session without documented distinct work
Insufficient conservative treatment documented prior to authorization or claim submission
Missing or vague operative note that does not specify chondroplasty, abrasion arthroplasty, or labral resection by name
29862 billed when labrum was repaired with sutures or anchors — correct code in that scenario is 29916

Frequently asked questions

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

01Can 29862 be billed with 29916 in the same operative session?

Generally no. 29916 (labral repair) includes chondroplasty, synovectomy, and acetabuloplasty in its descriptor, so most payers and NCCI edits treat 29862 as bundled into 29916. If distinct, separately identifiable work supports both codes, modifier 59 is required and documentation must clearly justify it — expect scrutiny.

02What's the difference between 29862 and 29916?

29862 is debridement and resection — cartilage shaving, abrasion arthroplasty, or trimming away damaged labral tissue. 29916 is labral repair with sutures or anchors. If the labrum was reconstructed or sutured, 29916 is the correct code. Using 29862 when a repair was performed undercodes the claim and misrepresents the work.

03Does 29862 cover labral resection or only cartilage work?

Both. The code explicitly covers chondroplasty, abrasion arthroplasty, and/or resection of the labrum. The operative note should specify which of those was performed. Coding 29862 solely on the basis of a labral resection without cartilage work is supported by the code descriptor.

04How do major payers treat 29862 for medical necessity?

Aetna considers isolated hip arthroscopic debridement experimental and unproven, and treats debridement performed with FAI surgery as integral to 29914/29915/29916. BCBS Florida requires documented conservative treatment failure and radiologically confirmed pathology. Obtain prior authorization and confirm payer-specific clinical criteria before scheduling.

05Which modifiers are most commonly needed when billing 29862?

LT or RT to lateralize the procedure. Modifier 51 when 29862 is a secondary procedure in a multi-code session. Modifier 59 if billing alongside codes that NCCI bundles with 29862 and distinct work is documented. Modifier 78 for an unplanned return to the OR for a related issue within the 90-day global period.

06Is the 90-day global period the same for HOPD and ASC settings?

The 90-day global period is a CMS Physician Fee Schedule rule and applies to the surgeon's professional fee regardless of site of service. The facility payment rates differ significantly between HOPD and ASC settings — see the Site of Service comparison on this page. The global period itself does not change by site.

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 specific arthroscopic interventions performed — chondroplasty, abrasion arthroplasty, labral resection — directly from the surgeon's dictation, along with pre-op imaging findings, Tönnis grade, and conservative treatment history. This prevents the most common audit flag on 29862: an operative note that documents 'debridement' without specifying which of the three covered procedures was actually performed, and without the clinical context payers require to clear medical necessity review.

See how Mira captures CPT 29862 documentation