Arthroscopy · Knee

29889

Arthroscopic repair or augmentation of the posterior cruciate ligament (PCL) of the knee, performed under endoscopic visualization.

Verified May 8, 2026 · 6 sources ↓

Medicare
$1,132.29
Total RVUs
33.9
Global, days
90
Region
Knee
Drawn from CMSAAOSAAPC

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

  • Specify whether the procedure was a repair of native PCL tissue or an augmentation with graft, and identify graft source (autograft vs. allograft) if applicable
  • Document the arthroscopic portals used and the surgeon's intraoperative findings, including PCL injury grade or pattern
  • Record each compartment examined and any additional pathology addressed, with compartment-level detail to support add-on codes like G0289
  • Include imaging correlation (MRI characterization of PCL tear) in the preoperative record to establish medical necessity
  • Operative note must name the specific technique — primary repair, reconstruction, or augmentation — not a generic phrase like 'PCL procedure'

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 29889 covers arthroscopic surgery on the knee in which the surgeon addresses a torn or insufficient posterior cruciate ligament — either by direct repair of native tissue or by augmenting it with a graft. The procedure is performed entirely through arthroscopic portals. Because the PCL is a deep, complex structure, 29889 is among the highest-RVU knee arthroscopy codes in the 29866–29889 series.

The 90-day global period means the surgical fee bundles the day-before decision visit (use modifier 57 on the E/M), the procedure itself, and all routine follow-up through day 90. Any E/M for an unrelated condition during that window requires modifier 24. A staged or planned return surgery gets modifier 58; an unplanned return for a related complication gets modifier 78; an unplanned return for an unrelated problem gets modifier 79.

NCCI policy explicitly prohibits separately reporting 29874 or 29877 with any code in the 29866–29889 range on the same knee at the same encounter. G0289 is the correct add-on when loose body removal or chondroplasty is performed in a different compartment of the same knee during the same session. Diagnostic arthroscopy is bundled into 29889 and cannot be billed separately.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU16.97
Practice expense RVU13.32
Malpractice RVU3.61
Total RVU33.9
Medicare national rate$1,132.29
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
$1,132.29
HOPD (APC 5115)
Hospital outpatient department
$13,116.76
ASC (PI J8)
Ambulatory surgical center (freestanding)
$9,934.11

Common denial reasons

The recurring reasons claims for CPT 29889 get rejected.

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

  • Medical necessity not established — payer requires pre-auth or documented failure of conservative treatment before approving PCL arthroscopy
  • 29874 or 29877 billed on the same claim line for the same knee encounter, triggering automatic NCCI bundling denial
  • Modifier 57 omitted on a same-day or day-before E/M visit that falls in the global period of this 90-day code
  • Laterality modifier (LT or RT) missing on the claim, causing payer to reject for incomplete billing information
  • Operative report describes only diagnostic arthroscopy without clearly documenting the therapeutic PCL repair or augmentation work

Frequently asked questions

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

01Can 29889 be billed with 29881 (meniscectomy) on the same knee at the same session?
Yes, with modifier 51 on the secondary code. The NCCI prohibitions in the 29866–29889 range target 29874 and 29877 specifically — meniscectomy codes like 29880 and 29881 are not blanket-bundled with 29889. Confirm current NCCI PTP tables before billing, as edits update quarterly.
02What modifier do I use if the surgeon decides on PCL surgery during an office visit the day before the OR?
Append modifier 57 to the E/M code. Modifier 57 flags the visit as the decision-for-surgery encounter for a major (90-day global) procedure, allowing separate payment for that E/M.
03Can 29874 or 29877 be billed with 29889 if loose body removal was done in a separate compartment?
No for 29874 and 29877 — NCCI explicitly prohibits those codes with any code in the 29866–29889 series on the same knee at the same encounter. Use G0289 instead when the debridement or loose body removal occurs in a different compartment.
04Is modifier 50 appropriate if PCL procedures are performed bilaterally?
Bilateral PCL surgery in a single session is exceedingly rare clinically, but if it occurs, modifier 50 is the correct approach. Document distinct pathology and surgical findings for each knee. Most payers require a bilateral indicator on the code to process modifier 50 correctly — verify 29889's bilateral indicator status in the current PFS.
05The patient returns six weeks post-op with a new acute meniscal tear. What modifier applies?
Modifier 79 — unrelated procedure during the postoperative global period. The new meniscal tear is anatomically related to the knee but clinically unrelated to the PCL repair, which is the standard for modifier 79 application. Modifier 78 would be incorrect here because 78 is reserved for an unplanned return to the OR for a complication of the original surgery.
06What justifies modifier 22 on 29889?
Substantially increased operative work beyond the typical PCL repair — for example, a revision with significant scarring, multiply ligament-injured knee requiring extensive reconstruction, or unusual anatomic complexity documented in the operative report. The note must quantify why the work exceeded the norm; a vague reference to 'complexity' will not survive audit.

Mira AI Scribe

Mira's AI scribe captures the PCL injury classification, the surgical technique (repair vs. augmentation), graft type and harvest site if applicable, compartments visualized, and any additional intraoperative findings by compartment. That compartment-level detail is what separates a supportable G0289 add-on from an NCCI denial, and the explicit technique description prevents a payer from downcoding 29889 to a lower-value knee arthroscopy code.

See how Mira captures CPT 29889 documentation

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