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CPT 29827: Arthroscopic Rotator Cuff Repair, Shoulder
CPT code 29827 denotes an arthroscopic repair of a torn rotator cuff, a commonly performed minimally invasive shoulder surgery to reattach and repair torn tendon tissue. Nationally, this code is central to musculoskeletal surgical billing for sports-related and overuse shoulder injuries that cause pain and functional limitations. The code captures a defined surgical service often performed in outpatient surgical settings and is relevant to surgical specialists in orthopaedics and sports medicine.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for arthroscopic rotator cuff repair, expected service settings, typical associated diagnoses, and related procedural codes used for bundling and comparison. The publication also outlines common coding neighbors such as arthroscopic decompression and open rotator cuff repair to aid in distinguishing service levels.
This analysis highlights coding scope, clinical indications, and useful cross-references for claims and coding teams, revenue cycle professionals, and clinical leaders. It provides national-level context without state-specific rules and points toward where providers commonly align documentation and code selection for arthroscopic rotator cuff repair.
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Billing Code Overview
CPT code 29827 describes an arthroscopic repair of a torn rotator cuff. The procedure involves insertion of an arthroscope to examine the tissues inside the shoulder joint, followed by use of additional instruments to repair the torn tendons and muscles that make up the rotator cuff.
Service Type: Surgical — Arthroscopic rotator cuff repair
Typical Site of Service: Hospital outpatient department or ambulatory surgery center, with procedure performed in an operating room or procedure suite under regional or general anesthesia.
National Reimbursement Benchmarks
Nationally, Medicare’s mean allowed amount for CPT 29827 sits at $993, noticeably below the BUCA commercial average of $3,226.50. This gap of $2,233.50 underscores a substantial difference between federal fee schedules and aggregated commercial contracting levels, with BUCA roughly 3.25 times Medicare’s mean.
Dispersion across payers varies: Blue Cross Blue Shield has the widest interquartile spread (P75–P25 = $4,704.90), indicating large variability in mid-to-upper commercial rates, while Aetna shows a tighter spread ($1,190.00). UnitedHealth Group ($1,146.20) and Cigna ($1,230.70) sit in the middle. BUCA’s interquartile spread is $3,196.40 and Medicare’s spread is narrow at $75.00, reflecting much more consistency in Medicare locality pricing than in most commercial contracts.