Summary & Overview
CPT 29867: Arthroscopic Knee Articular Cartilage Transplantation
CPT code 29867 identifies arthroscopic knee procedures that inspect the joint and transplant donor articular cartilage to repair focal cartilage defects. This code reflects advanced arthroscopic reconstruction aimed at relieving pain and improving range of motion by restoring damaged cartilage surfaces. Nationally, such procedures are important for musculoskeletal care pathways that can affect functional outcomes and downstream utilization of joint replacement.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides an overview of payer coverage patterns and common billing practices for cartilage transplantation performed arthroscopically, though specific coverage policies vary by plan.
Readers will find: a clear clinical context for CPT code 29867, expected sites of service, common modifiers used in practice (listed separately), and a description of what benchmarks and policy topics are typically relevant for this service. The summary highlights where data is available and flags areas where input data was not provided. The content is geared to billing managers, policy analysts, and clinical leaders seeking a concise, national-level briefing on this specific arthroscopic cartilage transplantation procedure.
Billing Code Overview
CPT code 29867 describes an arthroscopic procedure in which the provider inspects the interior of the knee joint and transplants healthy articular cartilage from a donor source to replace damaged cartilage. The service involves the use of an arthroscope and surgical instruments to visualize, assess, and implant donor cartilage into areas of focal cartilage loss.
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Service type: Arthroscopic knee articular cartilage transplantation/repair
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Typical site of service: Hospital outpatient department or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 34-year-old recreational athlete presents with persistent anterior knee pain, mechanical catching, and limited range of motion after failed conservative care for a focal cartilage defect of the femoral condyle. Imaging (MRI) demonstrates a symptomatic full-thickness chondral lesion measuring approximately 2.0 cm². The orthopedic surgeon plans an arthroscopic-assisted osteochondral allograft transplantation of the knee to restore articular cartilage surface and relieve pain.
Preoperative workflow includes history and physical, informed consent discussing risks/benefits, review of MRI and graft availability, medical clearance, and anesthesia evaluation. In the operating room under general or regional anesthesia, standard arthroscopic portals are established. Diagnostic arthroscopy confirms the lesion. Arthroscopic debridement and preparation of the defect are performed; instruments are used to size and implant donor osteochondral or chondral graft material into the defect with fixation as needed. Hemostasis is achieved, portals closed, and the patient is recovered with a postoperative plan that includes protected weight-bearing, physical therapy, and follow-up imaging.
Typical site of service: Hospital outpatient department or ambulatory surgery center. Service type: Arthroscopic cartilage transplantation (allograft/autograft) of the knee intra-articular procedure.
Coding Specifications
| Modifier | Description | When to Use |
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