Arthroscopy · Knee

Knee arthroscopy performed specifically to cut and release intra-articular adhesions, with or without manipulation of the joint to restore range of motion.

Verified May 8, 2026 · 6 sources ↓

Medicare: $586.19
Total RVUs: 17.55
Global, days: 90
Region: Knee

Drawn from CMSAAPCPriorityhealth

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 or left knee) in both the operative note and the order
Identify the compartments entered arthroscopically and location of adhesions
Document the nature, extent, and clinical significance of adhesions — distinguish pathologic fibrosis from incidental findings
Record whether manipulation was performed and the arc of motion achieved before and after the procedure
State the indication: prior surgery, trauma, infection, or prolonged immobilization leading to arthrofibrosis
Confirm that no other concurrent arthroscopic knee procedures were performed in the same session, given the separate procedure designation

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 51 Multiple procedures 58 Staged or related 59 Distinct service 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 ↓

29884 covers a surgical knee arthroscopy in which the primary goal is lysis — cutting or releasing — of adhesions inside the joint, with or without concurrent manipulation to recover motion. It is designated a 'separate procedure' in CPT, which has a hard consequence: you cannot report 29884 alongside any other arthroscopic knee procedure on the same knee at the same encounter, regardless of payer. This isn't a modifier-59 situation you can work around — the separate procedure designation prohibits it.

The procedure is most commonly indicated for arthrofibrosis or stiff knee syndrome following prior surgery, infection, or prolonged immobilization. The arthroscope is introduced, adhesions are identified and lysed with instruments, and the surgeon may then manipulate the knee to achieve additional range of motion gains. Document the compartments entered, the nature and location of adhesions, the manipulation technique if performed, and the degree of motion recovered at the end of the case.

The 90-day global period applies. Any return to the OR for an unrelated procedure during that window requires modifier 79; an unplanned return for a related complication requires modifier 78. Laterality must be captured with LT or RT — payers routinely deny claims missing side specificity for knee procedures.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.07
Practice expense RVU	7.82
Malpractice RVU	1.66
Total RVU	17.55
Medicare national rate	$586.19
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	$586.19
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 29884 get rejected.

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

Unbundling: 29884 billed alongside another arthroscopic knee code on the same knee — the separate procedure designation prohibits this combination
Missing or incorrect laterality modifier — LT or RT required; absence triggers payer rejection
Medical necessity not established — documentation lacks a diagnosable cause of adhesion formation (e.g., prior surgery, arthrofibrosis diagnosis) and fails to show conservative treatment exhausted
Osteoarthritic knee pain as the sole indication — CMS policy excludes arthroscopic debridement/lysis for patients presenting with knee pain only from osteoarthritis
Global period conflict — procedure billed within the 90-day global of a prior knee arthroscopy without the appropriate modifier (78 or 79)

Frequently asked questions

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

01Can I bill 29884 with 29881 (partial meniscectomy) on the same knee in the same session?

No. 29884's separate procedure designation means it cannot be reported with any other arthroscopic knee procedure on the ipsilateral knee at the same encounter — not for Medicare, not for commercial payers. There is no modifier that unlocks this combination.

02Is modifier 59 ever valid with 29884?

Not when adding another ipsilateral arthroscopic knee procedure — the separate procedure rule blocks it regardless of modifier. Modifier 59 may apply in other billing contexts, such as distinguishing 29884 from a non-arthroscopic service on the same date, but it cannot override the same-knee same-session restriction.

03What ICD-10 codes best support medical necessity for 29884?

M23.5x (chronic instability of knee), M24.561–M24.562 (contracture of knee), T84.89xA/D/S (complication of orthopedic implant), and M25.661–M25.662 (stiffness of knee) are commonly used. The diagnosis should reflect arthrofibrosis or a documented motion deficit with a causative history.

04Does the 90-day global period from a prior TKA or knee arthroscopy affect billing 29884?

Yes. If 29884 is performed during the 90-day global of a prior knee procedure, you need modifier 78 if it's an unplanned return for a related issue (e.g., post-op stiffness) or modifier 79 if it's unrelated. Missing these modifiers results in automatic denial.

05What is the site-of-service difference between HOPD and ASC for 29884?

There is a significant facility payment differential between the hospital outpatient department and ASC settings under CMS Physician Fee Schedule 2026. See the site-of-service comparison table on this page for the specific HOPD and ASC facility payment rates.

06Can 29884 be billed bilaterally in the same session?

Bilateral lysis of adhesions in the same session is rare but would require modifier 50 (or LT and RT on separate lines per payer preference). Each payer handles bilateral arthroscopy payment differently — verify your contract before assuming 150% reimbursement.

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 indication for lysis (prior surgery, arthrofibrosis, stiff knee), the compartments entered, adhesion location and extent, whether manipulation was performed, and the pre- and post-procedure range of motion. This prevents the two most common denials: a vague operative note that can't support medical necessity, and missing documentation that no concurrent arthroscopic procedure was performed — which would trigger a separate-procedure bundling rejection.

See how Mira captures CPT 29884 documentation