Arthroscopy · Knee

Arthroscopic knee surgery performed specifically to locate and remove loose or foreign bodies from within the joint space.

Verified May 8, 2026 · 7 sources ↓

Medicare: $506.02
Total RVUs: 15.15
Global, days: 90
Region: Knee

Drawn from AAPCAses-assnPriorityhealthCMS

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Specify the size of the loose or foreign body relative to the arthroscopic cannula diameter used — documentation must confirm the body was at least as large as the cannula
Document the method of removal: larger cannula, enlarged portal, or separate incision — bodies washed out during lavage are not separately billable
Identify the compartment where the loose body was found and removed (required for Medicare G0289 vs. 29874 determination)
Record the nature and origin of the loose body (e.g., osteochondritis dissecans fragment, chondral fragmentation, foreign body)
State whether this was the sole arthroscopic procedure performed, or describe all concurrent knee arthroscopy procedures and their compartments
Include pre-op diagnosis supporting mechanical symptoms attributable to the loose body (locking, catching, pain)

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 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 7 cited references ↓

29874 covers arthroscopic removal of loose or foreign bodies from the knee joint — fragments such as detached osteochondral pieces, chondral debris, or other material causing mechanical symptoms. To bill this code separately, the body being removed must be at least as large as the diameter of the arthroscopic cannula used, and removal must occur through a larger cannula, an enlarged portal, or a separate incision. Bodies simply washed out during lavage do not meet that threshold and cannot be separately reported.

The most critical billing distinction for 29874 is the Medicare vs. non-Medicare split. For Medicare patients, 29874 cannot be reported alongside any other knee arthroscopy code (29866–29889). When loose body removal occurs with another knee arthroscopic procedure on a Medicare patient and meets compartment criteria, report G0289 instead. For non-Medicare patients, AAOS Global Service guidelines permit reporting 29874 with a primary service such as meniscectomy when size or separate-incision criteria are met — use modifier 59 (or an X modifier) to identify the distinct service.

The 90-day global period applies. Any E/M visit or procedure billed within that window for a related condition requires modifier 24 or 79 respectively. Diagnostic arthroscopy (29870) is always bundled into 29874 and cannot be reported separately at the same encounter.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	7.01
Practice expense RVU	6.72
Malpractice RVU	1.42
Total RVU	15.15
Medicare national rate	$506.02
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	$506.02
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 29874 get rejected.

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

Bundling denial when 29874 is reported alongside another knee arthroscopy code (29866–29889) on a Medicare claim — G0289 is required instead
Medical necessity denial when documentation fails to confirm the loose body met the size threshold relative to the arthroscopic cannula diameter
Unbundling flag when diagnostic arthroscopy 29870 is billed on the same day as 29874 — 29870 is always included
Modifier 59 absent or unsupported on non-Medicare claims where 29874 is billed with a primary knee arthroscopy code without documented size or separate-incision criteria
Denial for loose body removal performed solely by lavage — payers and NCCI require formal retrieval, not incidental washout

Frequently asked questions

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

01Can I bill 29874 with a meniscectomy (29880 or 29881) on a Medicare patient?

No. On Medicare claims, 29874 cannot be reported alongside any knee arthroscopy code in the 29866–29889 range. When loose body removal meets the separate-compartment criterion during a meniscectomy, report G0289 instead of 29874.

02Can I bill 29874 with a meniscectomy on a non-Medicare patient?

Yes, under AAOS Global Service guidelines, if the loose body is greater than 5 mm and/or removed through a separate incision, 29874 is separately reportable alongside 29880 or 29881. Attach modifier 59 to 29874 and document the qualifying criteria in the operative note.

03Does the number of loose bodies removed affect billing — can I bill 29874 twice if bodies were found in two compartments?

No. 29874 is reported once regardless of how many loose bodies are removed. Multiple removals in different compartments on a Medicare patient may support G0289 for the additional compartment, but 29874 itself has a MUE of one per encounter.

04What is G0289 and when do I use it instead of 29874?

G0289 describes arthroscopic removal of a loose or foreign body performed at the time of another knee arthroscopy in a different compartment of the same knee. Use G0289 on Medicare claims when loose body removal accompanies another knee arthroscopic procedure and the separate-compartment criterion is met. G0289 is Medicare-specific; private payers generally do not recognize it.

05Does a loose body washed out during joint lavage qualify for separate billing under 29874?

No. Lavage alone does not meet the reporting threshold. The operative note must document formal retrieval — either through a cannula larger than the working cannula, a portal enlarged for extraction, or a separate incision. Without that, 29874 will not survive audit or payer review.

06What global period applies to 29874 and what does it cover?

29874 carries a 90-day global period. Routine post-op visits, wound checks, and related care within 90 days are included. Bill unrelated procedures in the global window with modifier 79; bill related E/M visits with modifier 24.

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 size of each loose or foreign body relative to the arthroscopic cannula, the removal method (enlarged cannula, widened portal, or separate incision), the compartment of origin, and whether any concurrent knee arthroscopic procedures were performed. That detail directly determines whether 29874 or G0289 is correct on Medicare claims and whether modifier 59 is defensible on commercial claims — preventing the most common bundling denials for this code.

See how Mira captures CPT 29874 documentation