Summary & Overview

CPT 29889: Arthroscopic Posterior Cruciate Ligament Repair

CPT code 29889 denotes arthroscopic repair of the posterior cruciate ligament (PCL) in the knee, a minimally invasive surgical procedure that inspects intra-articular structures and reconstructs the torn ligament using autograft or allograft tissue. Nationally, this code matters because PCL injuries, though less common than ACL tears, require specialized surgical intervention that impacts hospital outpatient and ambulatory surgery utilization, device and graft sourcing, and postoperative rehabilitation pathways. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise clinical and billing profile of CPT code 29889, including typical sites of service and service type, common payer coverage patterns, and the practical context for utilization in orthopedic practice. The publication also outlines benchmarking expectations and relevant policy considerations affecting prior authorization, coverage of allograft versus autograft materials, and ambulatory surgery scheduling. Clinical context covers indications, expected outcomes (pain relief and improved mobility), and the role of arthroscopy in enabling less invasive PCL reconstruction. Data not provided in the input—such as detailed payer-specific reimbursement rates, ICD-10 linkage, or taxonomies—is noted as unavailable where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 29889arthroscopyposterior cruciate ligamentknee surgeryorthopedicsoutpatient surgeryPCL repairligament repairsurgical procedure

Billing Code Overview

CPT code 29889 describes an arthroscopic procedure in which the provider inspects the interior of the knee joint with an arthroscope, identifies a tear of the posterior cruciate ligament (PCL), and repairs the ligament. The repair may use autograft tissue taken from elsewhere in the knee or, when required, an allograft donor source. This procedure is intended to relieve pain and improve joint mobility.

Service type: Arthroscopic PCL repair (knee)
Typical site of service: Hospital outpatient department or ambulatory surgery center

Clinical & Coding Specifications

Clinical Context

A 32-year-old recreational soccer player presents with acute posterior knee pain and instability after a twisting injury during play. Physical exam demonstrates positive posterior drawer and laxity consistent with posterior cruciate ligament (PCL) injury. MRI confirms a PCL tear with persistent symptoms despite conservative treatment (physical therapy, bracing) over 3 months. The orthopedic surgeon schedules arthroscopic PCL reconstruction using an autograft harvested from the patient’s hamstring or patellar tendon, with possible allograft if autograft quality is inadequate. The procedure is performed in an ambulatory surgery center or hospital operating room under general or regional anesthesia. Intraoperative steps include diagnostic arthroscopy, evaluation of intra-articular structures, debridement of torn ligament remnants, creation of tibial and femoral tunnels, graft fixation, and confirmation of graft tension and knee stability. Postoperative workflow includes recovery in PACU, pain management, immobilization or bracing, and a documented plan for progressive rehabilitation with weight-bearing and range-of-motion milestones, with follow-up clinic visits for suture removal and postoperative assessment.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or technical difficulty substantially exceeds typical for the procedure.
`52`	Reduced services	Use when procedure is partially reduced or not completed as planned.
`59`	Distinct procedural service	Use when a separate, distinct service is performed at a separate anatomic site or encounter.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons for distinct portions of the procedure.
`66`	Surgical team	Use when a surgical team (multiple qualified surgeons) performs the procedure.
`73`	Discontinued outpatient procedure prior to anesthesia administration	Use when the procedure is cancelled after the patient is prepared but before anesthesia start.
`76`	Repeat procedure by same physician (note: not in provided list)	Data not available in the input.
`78`	Return to OR for a related procedure during the global period	Use when patient returns to the OR for complications related to the original procedure during the global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon (not a co-surgeon) assists during the procedure.
`AS`	Ambulatory surgery center facility service	Use to indicate the service was provided in an ASC.
`LT`	Left side	Use to indicate the procedure was performed on the left knee.
`RT`	Right side	Use to indicate the procedure was performed on the right knee.

Taxonomy Code	Specialty	Notes
207X00000X	Orthopedic Surgery	Primary specialty performing arthroscopic PCL reconstruction.
2080P0106X	Sports Medicine (Orthopedic)	Subspecialty focus on athletic knee injuries and reconstruction.
208600000X	General Surgery	Occasionally involved in systems where orthopedic surgeons are not available; less common.
208100000X	Physical Medicine & Rehabilitation	Provides postoperative nonoperative management and rehabilitation planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S83.241A`	Complete tear of posterior cruciate ligament of right knee, initial encounter	Direct indication for PCL reconstruction when instability or functional impairment is present.
`S83.242A`	Complete tear of posterior cruciate ligament of left knee, initial encounter	As above, for the left knee.
`S83.249A`	Complete tear of posterior cruciate ligament of unspecified knee, initial encounter	Use when laterality is not specified at initial encounter.
`M23.81`	Other spontaneous disruption of joint, knee	Chronic instability or degenerative PCL insufficiency leading to reconstruction.
`M23.2`	Derangement of meniscus due to old tear or injury	Meniscal pathology commonly encountered and addressed during arthroscopy.
`M25.561`	Pain in right knee	Symptom driving evaluation and indication for surgical management when mechanical symptoms persist.
`M25.562`	Pain in left knee	As above for left knee.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29870`	Arthroscopy, knee, diagnostic, with or without synovial biopsy	Often performed at the start of surgery for diagnostic assessment of intra-articular pathology before PCL reconstruction.
`29888`	Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction	Performed for ACL pathology; may be performed concurrently if multi-ligament injury exists.
`29882`	Arthroscopy, knee, with meniscal repair (medial OR lateral)	Often performed concomitantly to address meniscal tears identified during arthroscopy.
`20930`	Allograft, fresh or processed, musculoskeletal tissue, for graft when performed	Billed when an allograft source is used for PCL reconstruction.
`20660`	Removal of implanted material, deep (e.g., deep percutaneous or open)	May be used if hardware removal is required in a staged or subsequent procedure.
`29879`	Unlisted arthroscopic procedure, knee	Use when a specific arthroscopic step is unconventional and not represented by existing codes; rarely used for novel techniques.