Knee arthroscopy CPT codes: what 29870 to 29883 mean on your bill

The short answer: one facility payment, twelve surgeon fees

Hospital outpatient payment groups procedures into Ambulatory Payment Classifications, or APCs. A knee arthroscopy code carries status indicator J1, which marks a comprehensive APC: the hospital gets one payment for the procedure and most related services on the claim are packaged into it instead of being paid line by line. CMS put the whole 29870 to 29883 family into APC 5113, Level 3 Musculoskeletal Procedures, so the facility amount is $3,342.87 whichever code was billed, with a minimum unadjusted copayment of $668.58.

The surgeon is paid under a different system, the Physician Fee Schedule, where each code has its own amount. That is where the family spreads out: $416.54 at the low end and $829.87 at the high end, a gap of $413.33 on the surgeon line while the facility line stays fixed. A cash price or a commercial plan allowed amount follows its own rates, but the Medicare shape holds as a rule of thumb: the building sets the facility line, the code sets the surgeon line.

Every code in the family also carries a 090 global period in the fee schedule file. Routine related follow-up visits with the surgeon for 90 days after the procedure are part of the surgeon anchor. The global period guide explains what that covers and what it leaves out, and physical therapy is one of the things it leaves out.

The full family: all twelve codes with CY2026 Medicare anchors

The table below lists every code in the knee arthroscopy family. The plain-words column is our paraphrase of what the code covers; the surgeon column is the CY2026 Medicare Physician Fee Schedule facility amount for Michigan Locality 01, computed by MyCarePrice from the CMS RVU26D relative value file (October 2026 release), the CY2026 geographic indices and the $33.4009 conversion factor. The hospital column is the same for every row because the OPPS payment is the same for every code in the family. Amounts are Medicare anchors, not cash prices and not your bill.

Source: CMS PFS RVU26D and GPCI2026, Michigan Locality 01, CY2026; CMS OPPS October 2026 Addendum B, APC 5113, status indicator J1. Computed and checked November 11, 2026. Medicare anchors, not your bill. The 29880 and 29881 surgeon anchors match the figures already published on this site's knee arthroscopy procedure page.

Three things in the table are worth noticing before you look at any price list. First, the diagnostic code, 29870, is the only code with different amounts by setting: $612.51 in a nonfacility setting against $416.54 in a facility. The surgical codes carry the same amount in both columns because they are facility procedures. Second, repair pays more than removal on the surgeon line: 29882 at $675.23 against 29881 at $539.38, a difference of $135.85 for one side. Third, one side against both sides is a real price step: 29880 at $558.25 against 29881 at $539.38, and 29883 at $829.87 against 29882 at $675.23.

Why the hospital line never moves

A comprehensive APC pays the hospital once for the whole service. Under status indicator J1, the operating room, the arthroscopy equipment, standard recovery, and most related services on the same claim are packaged into the single APC 5113 payment of $3,342.87. The hospital does not get a higher facility payment for a repair than for a diagnostic scope, and it does not get a lower one for a quick debridement. That packaging is also why the minimum unadjusted copayment is the same $668.58 for every code in the family: the copayment is figured on the APC payment, not on the code.

Two limits apply to that copayment. Medicare.gov states that the copayment for a single outpatient hospital service is usually capped at the Part A inpatient hospital deductible, which CMS set at $1,736.00 for 2026. The $668.58 minimum unadjusted copayment for this APC sits below that cap. And the figures are national unadjusted rates: the actual payment to a given hospital is adjusted for local wages, so the hospital line on a real bill can sit above or below the national figure while the pattern, one payment for the whole family, stays the same.

The setting is the lever that moves the facility line. A hospital outpatient department is paid under OPPS; a freestanding ambulatory surgery center is paid under the ASC payment system, which sets its own facility fee for the same code, typically lower than the hospital amount for the same procedure. The surgeon anchor does not change with the building. The surgery center guide works through that comparison, and the facility fee guide explains why one visit can produce two bills. Ask for the facility fee as its own written line, from each setting, before you compare quotes.

What the code changes: the surgeon line

The twelve codes split into groups that track the work actually done. A diagnostic scope, 29870, looks and may take a tissue sample; it is the only code in the family that involves no repair or removal. The infection code, 29871, is a washout. Lateral release, 29873, and removal of a loose body, 29874, are single-purpose surgical codes. The synovectomy pair, 29875 limited and 29876 major, differ by how much of the joint lining is removed, and the surgeon anchor steps from $496.59 to $646.13 between them. Debridement, 29877, smooths damaged cartilage, and abrasion arthroplasty, 29879, roughens a joint surface.

The meniscus codes are the ones most people meet, and they turn on two distinctions: removal against repair, and one side against both. Removal is a meniscectomy: 29881 for one side (medial or lateral) at $539.38, 29880 for both sides at $558.25. Repair is sewing the meniscus instead of removing it: 29882 for one side at $675.23, 29883 for both sides at $829.87. The site's procedure page for knee arthroscopy with meniscectomy carries the 29881 anchors and the one-compartment note; the repair codes were the gap this guide fills.

One more coding point matters when you read a bill. The meniscectomy descriptors include debridement or shaving of articular cartilage (chondroplasty) "when performed", which means cartilage shaving done during a meniscectomy is part of the meniscectomy code, not a second line. A bill that shows 29881 plus 29877 for the same knee on the same date deserves a question: the debridement should already be inside the meniscectomy code. The same logic applies across the family: the code names the main work of the session, and work folded into its description is not billed again on a separate line. The itemized-bill check gives the general procedure for working a line that looks duplicated.

The lines around the code

The CPT code is one line on a bill that usually has several. Anesthesia bills separately in both settings; the anesthesia guide explains how that line is built from base units, time units and the conversion factor. An assistant surgeon can bill on a separate line when one was present; the assistant surgeon guide covers when that line is legitimate. Pre-operative imaging and lab work ordered before surgery are billed under their own codes, and physical therapy after the procedure starts with its own evaluation code, such as 97161, then per-visit codes; the physical therapy guide prices those.

None of those lines is in the APC payment or the surgeon anchor, which is why an all-in quote has to name each one. A quote that says "knee arthroscopy, $X" without naming the code, the setting, the anesthesia line and the therapy plan cannot be checked against the bill that follows, because the bill will itemize exactly those pieces. Ask for the surgeon line, the facility line and the anesthesia line in writing, each with its code, before the procedure date.

A Medicare example, worked through

The table below works the arithmetic for a Medicare patient in a hospital outpatient department, with the Part B deductible already met, using the CY2026 Michigan Locality 01 anchors. Medicare.gov states the general rule: after the Part B deductible, you pay 20 percent of the Medicare-approved amount, and in a hospital outpatient setting you also pay a copayment to the hospital. The 2026 Part B deductible is $283.00; the rows below assume it is already met elsewhere, so only the 20 percent coinsurance and the hospital copayment apply.

The facility line is identical in all three rows, so the whole difference between the cheapest and the most expensive row is the surgeon anchor: the patient share runs from $751.89 for the diagnostic scope to $834.55 for the two-sided repair, a spread of $82.66 on the same facility payment. If the Part B deductible is not yet met, the first $283.00 of approved amounts in the year goes to the deductible before the 20 percent coinsurance starts. That is the fourth row: the allowed amount is unchanged at $3,882.25, but the patient share rises to $1,002.85, which is the $283.00 deductible plus 20 percent of the remaining $3,599.25. Supplemental coverage, a Medicare Advantage plan's own cost sharing, or Medicaid can change the patient share, so treat these rows as the shape of the arithmetic. Anesthesia and physical therapy would add their own lines on top.

How the surgeon anchor is computed

The surgeon anchors on this page are not quoted from a price list. Each one is computed from the CMS relative value file, the same file Medicare uses to pay physicians. Every CPT code carries three relative value units, or RVUs: work, practice expense, and malpractice. For 29881 the October 2026 file lists work 6.85, facility practice expense 7.19 and malpractice 1.40. Each RVU is multiplied by the geographic index for Michigan Locality 01, Detroit, which is 1.000 for work, 0.965 for practice expense and 1.686 for malpractice. The three products are added and multiplied by the CY2026 conversion factor, $33.4009. The result for 29881 is $539.38.

That method is checkable. Run the same arithmetic on 29880 and it returns $558.25, the figure already published on this site's procedure page, and on 93306 it returns $193.43, the echocardiogram global anchor published on the site's procedure pages. The conversion factor is national; the geographic indices are what make the anchor specific to Michigan Locality 01. A different locality would use different indices and get a different amount for the same code, which is one reason a fee schedule figure from another state cannot be quoted as your price. The OPPS side needs no such computation: the Addendum B file publishes the APC payment directly, $3,342.87 for APC 5113, and the minimum unadjusted copayment of $668.58 beside it.

Getting the price before surgery

Start with the code. Ask the surgical office which CPT code the planned procedure will use, and whether the plan is one side or both, removal or repair. Then ask each party for its line in writing: the surgeon fee, the facility fee for the setting you will actually be in, and the anesthesia fee. The cash price guide has the wording for that call, and the CPT lookup guide shows how to check a code against the fee schedules yourself.

If you are uninsured or not using insurance, the No Surprises Act entitles you to a Good Faith Estimate when the service is scheduled at least three business days ahead or when you ask. The Good Faith Estimate guide explains the estimate and the dispute window that opens when a final bill runs at least $400 above it. If you are using insurance, the plan's allowed amount for the exact code and setting is the number to ask for; the insured cost worksheet turns an allowed amount, your deductible status and your coinsurance into a per-procedure figure.

One warning belongs in any pre-surgery quote. The code on the quote is the planned code, and the code on the bill is the code for the work actually done. A surgeon who plans a meniscectomy can find the tear is repairable once inside the knee, and the billed code changes from 29881 to 29882 with it. That is normal surgical practice, not a billing error, but it changes the surgeon line by $135.85 on the Medicare anchor. Ask the surgical office, before the procedure, what happens to the price if the plan changes during surgery, and ask after it which code was actually billed and why.

A code-check worksheet for knee arthroscopy bills

The worksheet is a set of questions, not accusations. A code can change for a good surgical reason, and a bill can carry a line the quote missed because the plan changed mid-procedure. A precise question with a date and a code gets a precise answer. How to read an explanation of benefits shows where the allowed amount sits on the insurer's statement, and the appeal guide covers the filing windows if a claim is denied.

Knee arthroscopy billing questions

Fee schedule and cost-sharing citations

• CMS, Physician Fee Schedule relative value file RVU26D (October 2026 release, PPRRVU2026_Oct_nonQPP) and CY2026 GPCIs, Michigan Locality 01, $33.4009 conversion factor: every surgeon anchor on this page. Computed November 11, 2026.
• CMS, OPPS October 2026 Addendum B: APC 5113, status indicator J1, payment $3,342.87, minimum unadjusted copayment $668.58 for every code from 29870 to 29883. Checked November 11, 2026.
• Medicare.gov, Medicare costs: 2026 Part B deductible $283.00, 20 percent coinsurance after the deductible, outpatient hospital copayment usually capped at the Part A deductible of $1,736.00. Checked November 11, 2026.
• eCFR, 45 CFR 149.610: Good Faith Estimates for uninsured or self-pay individuals. Checked November 11, 2026.

General billing information, not medical, legal or insurance advice. Medicare anchors are not your bill, and a practice's own rates and a plan's allowed amounts can differ widely from them. Confirm your price in writing before service.