Summary & Overview
CPT 29828: Arthroscopic Biceps Tenodesis, Shoulder
CPT code 29828 denotes arthroscopic biceps tenodesis, a shoulder surgical procedure that inspects the joint with an arthroscope and secures the biceps tendon to correct instability or tendonitis. This procedure is commonly performed alongside treatment of coexisting shoulder disorders such as impingement, chronic instability, or degenerative changes. Nationally, the code captures a frequently performed minimally invasive shoulder repair with implications for surgical utilization, outpatient procedure patterns, and payer coverage policies.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, an overview of typical sites of service and service type, and the common modifiers associated with billing this code. The publication outlines benchmarks and reimbursement considerations relevant to hospitals and ambulatory surgery centers, and summarizes policy or coverage themes that affect authorization and payment for arthroscopic biceps tenodesis.
This summary provides clinicians, billing professionals, and policy analysts with the information needed to understand the clinical intent of CPT code 29828, typical care settings, and the payer context that shapes access and payment.
Billing Code Overview
CPT code 29828 describes arthroscopic surgery in which the provider inspects the interior of the shoulder joint with an arthroscope and inserts instruments to perform a biceps tenodesis. The procedure secures an unstable or inflamed biceps tendon—often performed to address biceps tendonitis and associated shoulder conditions such as chronic instability, arthritis, or impingement.
Service Type: Arthroscopic shoulder surgical repair (biceps tenodesis)
Typical Site of Service: Hospital outpatient department or ambulatory surgery center, performed in an operating room or procedure suite under regional or general anesthesia.
Clinical & Coding Specifications
Clinical Context
A 48-year-old right-hand–dominant patient presents with several months of anterior shoulder pain, mechanical catching, and activity-limiting weakness despite conservative care (physical therapy, anti-inflammatory medications, and corticosteroid injection). Clinical exam shows bicipital groove tenderness and positive Speed and Yergason tests. MRI arthrogram demonstrates partial tearing and instability of the long head of the biceps tendon with concomitant rotator cuff tendinopathy and labral fraying. The orthopedic surgeon schedules an arthroscopic shoulder procedure under general anesthesia with interscalene block. Intraoperatively the surgeon performs diagnostic glenohumeral arthroscopy, addresses chondrolabral pathology as indicated, and performs an arthroscopic biceps tenodesis to treat the unstable long head of the biceps tendon. Typical site of service is an outpatient ambulatory surgery center or hospital outpatient department. Expected clinical workflow includes preoperative evaluation and imaging, informed consent documenting indication for 29828, operative log and arthroscopy report detailing arthroscopic findings and fixation method, postoperative recovery in PACU, and routine orthopedic follow-up for wound check and rehabilitation planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician professional component separate from technical services (rare for surgical CPTs). |