Summary & Overview
CPT 29875: Arthroscopic Excision of Symptomatic Synovial Plica, Knee
CPT code 29875 denotes arthroscopic excision of a symptomatic synovial fold (plica) within the knee. Nationally, this code captures minimally invasive operative management for patients with localized synovial irritation or mechanical symptoms that limit function. The procedure is commonly performed in ambulatory surgical centers and hospital outpatient departments and influences utilization and cost patterns in orthopedic and sports medicine care.
Payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and the billing landscape relevant to this code. The publication summarizes benchmark considerations, common billing modifiers and claims practice themes, and how this code fits into procedural bundles and outpatient surgical workflows. It also outlines where to look for policy updates and coding guidance that affect payment and medical necessity determinations.
This overview is intended for coding managers, revenue cycle leaders, and clinicians seeking a national perspective on the clinical use and administrative handling of CPT code 29875. Data not available in the input for specific payer rates, ICD-10 pairings, and associated taxonomies.
Billing Code Overview
CPT code 29875 describes an arthroscopic procedure in which the provider inspects the interior of the knee joint with an arthroscope and removes a symptomatic fold of synovial tissue (synovial plica) that is inflamed or damaged. The procedure involves insertion of instruments through small portals to excise the offending synovial tissue and address pain and motion limitation caused by the lesion.
-
Service type: Arthroscopic synovectomy / excision of synovial plica
-
Typical site of service: Ambulatory surgical center or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 42-year-old recreational runner presents with progressive medial knee pain, intermittent swelling, and mechanical catching after a twisting injury three months prior. Physical exam demonstrates joint line tenderness and a positive McMurray test. Conservative care including NSAIDs, activity modification, and physical therapy produced limited improvement. MRI shows a complex tear and a symptomatic, inflamed synovial plica causing pain and motion limitation.
The orthopaedic surgeon schedules an arthroscopic knee procedure. In the operating room under general or regional anesthesia, standard anterolateral and anteromedial portals are established. A diagnostic arthroscopy is performed to inspect the articular surfaces, menisci, cruciate ligaments, and synovium. The surgeon inserts an arthroscope and instrumentation, identifies an inflamed synovial plica causing impingement, and excises the fold of synovial tissue (synovectomy / plica excision). Hemostasis is achieved, portals are closed, and a sterile dressing and knee compression are applied. The patient is recovered in PACU and discharged with postoperative analgesia and a plan for early mobilization and physical therapy.
Service Type: Surgical — Arthroscopy (knee)
Typical Site of Service: Hospital outpatient surgical suite or ambulatory surgery center (ASC)
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|