Summary & Overview
CPT 29826: Arthroscopic Shoulder Decompression and Coracoacromial Repair
CPT code 29826 represents arthroscopic shoulder decompression with repair of the coracoacromial ligament and related shoulder blade structures to address impingement that causes pain and functional limitation. This surgical code is clinically important because shoulder impingement is a common cause of shoulder pain and arthroscopic decompression is a frequent operative intervention that impacts surgical volume, outpatient resource use, and post-operative care pathways nationwide. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise understanding of the procedure’s clinical intent and typical care setting, plus practical billing context: common modifiers associated with the service, typical sites of service, and the code’s role in surgical service lines. The publication also provides benchmarks and policy-relevant notes where available, explains typical documentation elements that support medical necessity, and highlights related service-line considerations for ambulatory surgical centers and hospital outpatient departments. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 29826 describes an arthroscopic procedure in which the provider inspects the interior of the shoulder joint with an arthroscope, inserts additional instruments, and repairs the shoulder blade and coracoacromial ligament to relieve impingement-related irritation and pain. The procedure is focused on decompression of the subacromial space and repair of structures contributing to shoulder impingement.
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Service type: Arthroscopic shoulder decompression and ligament repair
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Typical site of service: Ambulatory surgical center or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 45-year-old manual laborer presents with several months of progressive right shoulder pain, painful arc with overhead activities, night pain, and limited range of motion. Conservative management including activity modification, nonsteroidal anti-inflammatory drugs, physical therapy, and a subacromial corticosteroid injection produced partial, temporary relief. Clinical exam demonstrates positive impingement signs and weakness with resisted abduction. Imaging (plain radiographs and MRI) shows subacromial bursitis and acromial morphology consistent with impingement with partial thickness rotator cuff fraying.
The orthopedic surgeon schedules an arthroscopic subacromial decompression with coracoacromial ligament release and acromioplasty. In the operating room under general anesthesia with regional block, the provider performs diagnostic glenohumeral arthroscopy using an arthroscope, inspects intra-articular structures, then places accessory portals to decompress the subacromial space. Instruments are used to excise inflamed bursal tissue, perform acromioplasty, and release the coracoacromial ligament to alleviate mechanical impingement. The procedure typically occurs in an ambulatory surgery center or hospital outpatient setting. Postoperative workflow includes PACU recovery, discharge with sling and analgesia, and outpatient physical therapy for gradual restoration of range of motion and strength.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service |