Arthroscopy · Hand

Arthroscopic surgery of the metacarpophalangeal joint with reduction of a displaced ulnar collateral ligament, such as a Stener lesion.

Verified May 8, 2026 · 5 sources ↓

Medicare: $552.45
Total RVUs: 16.54
Global, days: 90
Region: Hand

Drawn from CMSCgsmedicareEmedny

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Operative note must identify the specific MCP joint treated (e.g., thumb MCP) and confirm arthroscopic approach was used throughout
Document the presence of ulnar collateral ligament displacement and the reduction technique performed — generic references to 'ligament repair' are insufficient
Preoperative imaging or clinical findings supporting diagnosis of Stener lesion or displaced UCL (e.g., MRI, stress radiograph, or physical exam findings)
Confirm that the procedure was not converted to open; if converted, only the open code may be reported
If bilateral, document medical necessity for treating both MCP joints at the same operative session

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 52 Reduced services LT Left side RT Right side 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 29902 covers surgical arthroscopy of the metacarpophalangeal (MCP) joint specifically to reduce a displaced ulnar collateral ligament — the injury pattern commonly called a Stener lesion, seen in gamekeeper's or skier's thumb. The arthroscope is used to visualize the joint, assess ligament displacement, and reposition the ulnar collateral ligament to its anatomic insertion. This is a surgical code, not diagnostic; the reduction of the displaced ligament is the defining element that distinguishes it from 29901 (MCP arthroscopy with debridement) and 29900 (diagnostic MCP arthroscopy).

The 90-day global period applies. All routine post-op visits, dressings, and suture removals through day 90 are bundled. Do not report 29900 or 29901 on the same claim as 29902 — CPT guidelines explicitly prohibit it. If a converted-to-open procedure is required, report only the open code; neither 29902 nor a diagnostic arthroscopy code should accompany it.

Bilateral MCP joint procedures are uncommon but possible. For Medicare Part B, bill a single claim line with modifier 50. ASC billing uses separate LT and RT lines. The 90-day global and the low procedure volume for this code make documentation discipline especially important — payers scrutinizing a rare hand arthroscopy code will look hard at the operative note.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	6.98
Practice expense RVU	8.08
Malpractice RVU	1.48
Total RVU	16.54
Medicare national rate	$552.45
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	$552.45
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 29902 get rejected.

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

29900 or 29901 billed on the same claim — CPT explicitly prohibits reporting these with 29902
Operative note describes an open reduction but 29902 (arthroscopic) was submitted — code-to-documentation mismatch
Missing or vague documentation of UCL displacement and reduction; notes that reference only 'ligament work' or 'debridement' without specifying Stener-type lesion reduction
Incorrect site modifier when bilateral or when laterality is required by payer and omitted

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Can I bill 29900 or 29901 alongside 29902 when I also performed diagnostic work or debridement during the same session?

No. CPT guidelines explicitly prohibit reporting 29900 or 29901 with 29902. The surgical code 29902 subsumes the diagnostic and debridement components performed at the same MCP joint in the same session.

02What modifier do I use if the patient returns within the 90-day global for a related complication requiring return to the OR?

Use modifier 78 for an unplanned return to the OR for a procedure related to the original surgery. If the return is for a completely unrelated procedure, use modifier 79.

03How do I bill 29902 when performed bilaterally — one code or two?

For Medicare Part B physician billing, report one claim line with modifier 50. For ASC facility billing, report two separate claim lines using modifier LT on one and RT on the other, each with one unit of service.

04If the arthroscopic procedure is converted to open, can I still report 29902?

No. Per NCCI policy, when an arthroscopic procedure is converted to an open procedure, only the open procedure code is reported. Neither the arthroscopic code nor a diagnostic arthroscopy code should accompany it.

05What ICD-10 diagnoses support medical necessity for 29902?

Diagnoses documenting UCL injury of the thumb MCP joint with displacement — such as Stener lesion or complete UCL rupture with proximal phalangeal base displacement — align with this code. Payers expect imaging or stress exam findings in the record to substantiate surgical necessity over conservative management.

06Is a separate diagnostic arthroscopy code billable if I scoped the joint first to confirm the lesion before reducing it?

No. The diagnostic examination is integral to the surgical arthroscopy. NCCI policy requires that the medical record document medical necessity if a diagnostic arthroscopy is performed and a non-arthroscopic therapeutic procedure follows, but 29900 cannot be separately reported when 29902 is performed.

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 joint treated by name, the arthroscopic approach, the intraoperative finding of UCL displacement (Stener lesion pattern), and the specific reduction maneuver performed. It flags if the dictation omits the reduction step — the one element that separates 29902 from 29901 — preventing downcoding on audit.

See how Mira captures CPT 29902 documentation