Arthroscopy · Hip

29863

Arthroscopic surgical procedure on the hip joint involving removal of inflamed synovial membrane tissue.

Verified May 8, 2026 · 6 sources ↓

Medicare
$757.20
Total RVUs
22.67
Global, days
90
Region
Hip
Drawn from CMSFastrvuEventsAAPCSciencedirect

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

  • Confirmed diagnosis of synovitis or inflammatory synovial disease documented in pre-op and H&P notes
  • Operative report naming specific portals used and extent of synovial tissue excised
  • Pathology or specimen disposition noted if synovial tissue is sent for analysis
  • Medical necessity narrative explaining why conservative management was exhausted or insufficient
  • Laterality documented explicitly — left, right, or bilateral — matching the claim modifier
  • If billed same-session as 29862 or other hip arthroscopy codes, distinct anatomic or procedural basis documented for each

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 29863 covers hip arthroscopy performed specifically to excise hypertrophic or inflamed synovial tissue from within the hip joint. It is used for conditions driving synovitis — rheumatoid arthritis, pigmented villonodular synovitis (PVNS), chronic inflammatory arthropathy, and post-arthroplasty synovial irritation among them. The surgeon works through arthroscopic portals to visualize and resect the affected synovium, irrigate the joint, and confirm clearance before closure.

The code carries a 90-day global period. All routine post-op visits, wound checks, and related services within that window are included in the surgical payment — bill an unrelated E/M with modifier 24 if a distinct problem is addressed. When the operative session also includes labral debridement, chondroplasty (29862), or FAI correction (29914/29915/29916), NCCI bundling rules apply: 29863 is non-payable when billed alongside 29914, 29915, or 29916. Append modifier 59 only when a genuinely distinct service supports it — not as a routine bypass tool.

The procedure is performed in both hospital outpatient (HOPD) and ASC settings; site-of-service differences in facility payment are material. Diagnosis coding must support synovitis specifically — linking 29863 solely to articular cartilage pathology diagnoses (e.g., M24.151) without documenting synovial disease is a common trigger for denial.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU10.89
Practice expense RVU9.66
Malpractice RVU2.12
Total RVU22.67
Medicare national rate$757.20
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
$757.20
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 29863 get rejected.

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

  • Diagnosis code reflects articular cartilage pathology without documentation of synovial disease, creating a CPT-ICD mismatch
  • Bundled denial when 29863 is submitted alongside 29914, 29915, or 29916 without NCCI override authority
  • Medical necessity not established — no documentation of failed conservative treatment for synovitis
  • Missing laterality modifier causing claim rejection or payer-specific edit failure
  • Global period conflict when billed within 90 days of a prior hip surgical procedure without appropriate modifier

Frequently asked questions

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

01Can 29863 and 29862 be billed together for the same hip on the same day?
Yes, but expect scrutiny. NCCI does not automatically bundle 29862 with 29863, but the operative note must clearly document that both synovectomy and chondroplasty/labral debridement were performed as distinct services. Modifier 59 may be required. Use diagnosis codes that independently support each procedure.
02Is 29863 billable alongside 29914, 29915, or 29916?
No. Per NCCI policy, 29863 is non-payable when billed with 29914 (femoroplasty), 29915 (acetabuloplasty), or 29916 (labral repair). These combinations are in the non-payable column of the hip arthroscopy bundling table. There is no modifier override that makes them separately payable.
03What ICD-10 codes best support medical necessity for 29863?
Diagnoses documenting synovitis or inflammatory joint disease — such as M65.x5 (synovitis/tenosynovitis, hip), M06.x5 (rheumatoid arthritis, hip), or M12.x5 (PVNS, hip) — align directly with the procedure. Avoid linking 29863 solely to cartilage degeneration codes without a synovitis component.
04Does the 90-day global period affect billing for post-op visits after 29863?
Yes. Routine follow-up, wound checks, and procedure-related E/M services within 90 days are bundled into the surgical payment. For an E/M addressing an unrelated problem during the global period, append modifier 24. For a related return to the OR for an unplanned procedure, use modifier 78.
05How does site of service affect reimbursement for 29863?
The facility payment differs substantially between HOPD and ASC settings. The physician's professional fee is also affected by site-of-service rules — the non-facility RVU applies in settings where the physician bears overhead, while the lower facility RVU applies in HOPD and ASC. See the Site of Service comparison table on this page for current figures.
06Can 29863 be billed after a prior total hip arthroplasty on the same side?
Yes, it has been performed in post-THA patients, primarily for synovial irritation or iliopsoas impingement, though it is rare. If billed within the global period of the arthroplasty, modifier 79 is required to indicate an unrelated procedure. Document the distinct clinical indication clearly.

Mira AI Scribe

Mira's AI scribe captures the specific synovial compartments accessed, extent of synovectomy performed, portal placement, and the underlying inflammatory diagnosis driving the procedure. It flags when the operative dictation references only cartilage or labral findings without explicit synovitis language — the documentation gap most likely to produce a CPT-ICD mismatch denial on 29863.

See how Mira captures CPT 29863 documentation

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