Summary & Overview

CPT 29888: Arthroscopic Anterior Cruciate Ligament Repair/Reconstruction

CPT code 29888 represents arthroscopic anterior cruciate ligament (ACL) repair or reconstruction using autograft or allograft tissue. This surgical code is widely used in orthopedic practice to address ACL tears, a common injury that affects mobility and long-term joint health. Nationally, accurate coding of 29888 matters for clinical tracking, surgical quality measurement, and appropriate reimbursement for operative knee care.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for ACL reconstruction, typical sites of service (hospital outpatient departments and ambulatory surgery centers), and common billing modifiers associated with this service. The publication provides benchmarking guidance, payer coverage patterns, and policy updates relevant to outpatient musculoskeletal surgery coding.

The content also clarifies service-line implications for orthopedic and ambulatory surgical practices, highlights areas where documentation and coding precision affect payment and quality reporting, and outlines where to expect variation across commercial and public payers. Data not available in the input is explicitly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare29888CPTorthopedicsarthroscopyACL reconstructionsurgical-proceduresoutpatient-surgeryambulatory-surgery

Billing Code Overview

CPT code 29888 describes an arthroscopic surgical procedure in which the provider inspects the interior of the knee joint with an arthroscope, identifies a tear of the anterior cruciate ligament (ACL), and repairs the ligament using graft tissue from elsewhere in the patient's knee or, if needed, from a donor source. The procedure is intended to relieve pain and restore mobility in the knee joint.

Service type: Arthroscopic anterior cruciate ligament repair/reconstruction
Typical site of service: Hospital outpatient department or ambulatory surgery center, performed in an operating room setting

Clinical & Coding Specifications

Clinical Context

A 24-year-old recreational soccer player presents to the orthopedic clinic after a non-contact pivoting injury to the right knee. She reports immediate pain, swelling, and instability with episodes of the knee giving way. Physical exam demonstrates a positive Lachman test and anterior drawer test. MRI confirms a full-thickness tear of the anterior cruciate ligament (ACL) with associated medial meniscal fraying. The patient elects for arthroscopic ACL reconstruction.

The clinical workflow includes preoperative evaluation and imaging, informed consent, anesthesia evaluation (general or regional), and operating room arthroscopy. The surgeon performs diagnostic arthroscopy to inspect intra-articular structures, harvests autograft tissue (commonly hamstring tendon or patellar tendon), or uses an allograft if indicated, prepares tunnels in the femur and tibia, secures the graft with fixation devices, and addresses concurrent meniscal repair if required. Postoperative protocols include immobilization as needed, pain management, anticoagulation assessment, and initiation of structured physical therapy for progressive range of motion and strengthening to restore stability and function.

Coding Specifications

Modifier	Description	When to Use
`59`	Distinct Procedural Service	Use when reporting a separate, distinct procedure or service unrelated to another performed on the same day (e.g., arthroscopic ACL reconstruction performed with a separate unrelated arthroscopic procedure in a different anatomic compartment that qualifies as distinct).
`62`	Two Surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the ACL reconstruction.
`66`	Surgical Team	Use when a surgical team approach is documented and billed per payer rules (team surgery for complex reconstruction).
`51`	Multiple Procedures	Use when ACL reconstruction is performed with additional procedures (eg, meniscal repair) and payers require identification of multiple procedures.
`52`	Reduced Services	Use when the service is partially reduced or not completed as described (eg, aborted reconstruction due to intraoperative findings).
`53`	Discontinued Procedure	Use when the procedure is started but discontinued due to extenuating circumstances or patient safety.
`76`	Repeat Procedure by Same Physician	Use when the same physician repeats the procedure on the same day (less commonly applicable; include if a repeat ACL-related arthroscopy is medically necessary the same day).
`RT`	Right Side	Use to indicate the right knee when laterality is required for billing.
`LT`	Left Side	Use to indicate the left knee when laterality is required for billing.
`22`	Increased Procedural Services	Use when work required to perform the ACL reconstruction is substantially greater than typically required and supported by documentation (complex revision, severe scarring).

Taxonomy Code	Specialty	Notes
207X00000X	Orthopaedic Surgery	Primary specialty performing arthroscopic ACL reconstruction.
208200000X	Physical Medicine & Rehabilitation	Commonly involved in postoperative rehabilitation management.
363L00000X	Anesthesiology	Provides general or regional anesthesia for the procedure.
208000000X	Sports Medicine (Orthopaedic)	Subspecialists who frequently perform ACL reconstructions in athletes.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S83.51XA`	Sprain of anterior cruciate ligament of right knee, initial encounter	Represents acute ACL tear prompting reconstruction of the right knee.
`S83.52XA`	Sprain of anterior cruciate ligament of left knee, initial encounter	Represents acute ACL tear prompting reconstruction of the left knee.
`M23.51`	Other spontaneous disruption of anterior cruciate ligament, right knee	Chronic or spontaneous ACL disruption which may require reconstruction.
`M23.52`	Other spontaneous disruption of anterior cruciate ligament, left knee	Chronic ACL insufficiency on the left that may indicate reconstruction.
`M17.11`	Unilateral primary osteoarthritis, right knee	Degenerative changes occasionally present; influences surgical planning though not typical primary indication for ACL reconstruction.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29888`	Arthroscopically aided anterior cruciate ligament repair/ reconstruction or augmentation; with autograft (includes arthroscopy)	Primary procedure for ACL reconstruction; includes diagnostic arthroscopy and graft reconstruction.
`29881`	Arthroscopy, knee, surgical; synovectomy, limited	May be performed arthroscopically during the same session to address synovial pathology or symptomatic synovitis.
`29882`	Arthroscopy, knee, surgical; partial meniscectomy (medial OR lateral)	Commonly performed in the same operative setting when meniscal tears are present in conjunction with ACL injury.
`29883`	Arthroscopy, knee, surgical; meniscus repair (medial OR lateral)	Often performed alongside ACL reconstruction to repair meniscal tears and preserve meniscal function.
`29875`	Arthroscopy, knee, surgical; chondroplasty (abrasion/ debridement)	Performed intraoperatively to smooth articular cartilage lesions identified during diagnostic arthroscopy.