Summary & Overview
CPT 29916: Hip Arthroscopy with Labral Repair
CPT code 29916 denotes arthroscopic surgical repair of the hip labrum, a minimally invasive operative procedure to restore the fibrocartilaginous rim of the acetabulum after tear or degeneration. Nationally, this code captures a growing portion of hip-preserving surgical care as arthroscopic techniques expand and as recognition of femoroacetabular impingement and related labral pathology increases. The code is relevant to hospital outpatient departments and ambulatory surgery centers where most hip arthroscopies are performed.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, service and site-of-service characterization, and an overview of common billing considerations tied to arthroscopic hip labral repair. The publication highlights typical service settings and payer coverage landscapes, and outlines what to expect in terms of claims categorization and related coding considerations. Policy and reimbursement updates impacting hip arthroscopy are summarized to indicate areas where payer rules or prior authorization practices may influence utilization and billing. The content is intended for billing managers, orthopedic providers, and policy analysts seeking a concise national overview of the clinical procedure and its coding implications.
Billing Code Overview
CPT code 29916 describes arthroscopy of the hip with labral repair. The procedure involves use of arthroscopic techniques to visualize the hip joint and repair the acetabular labrum, a fibrocartilaginous rim that lines the socket (acetabulum) of the hip joint. Labral tears may arise from traumatic dislocation or from chronic mechanical abnormalities that cause degenerative wear and tear of the labrum.
Service type: Surgical — Orthopedic/Arthroscopic Hip Surgery
Typical site of service: Hospital outpatient department or ambulatory surgery center, with the procedure performed in an operating room or dedicated procedural suite.
Clinical & Coding Specifications
Clinical Context
A 28-year-old recreational athlete presents with months of anterior hip pain, mechanical clicking, and limited range of motion after a twisting sports injury. Imaging with MRI arthrogram demonstrates a labral tear of the acetabular rim with associated cam-type femoroacetabular impingement. After failure of conservative care (physical therapy, activity modification, and intra-articular steroid or hyaluronic acid injection), the patient is scheduled for hip arthroscopy with labral repair under general anesthesia.
Preoperative workflow includes history and physical, informed consent describing risks (infection, neurovascular injury, persistent pain), medication reconciliation, and imaging review. In the operating room the patient is placed supine or lateral on a traction table, portals are established, diagnostic arthroscopy performed, labral pathology identified, and arthroscopic labral repair performed using anchors and suture fixation (CPT 29916). Concomitant femoral osteochondroplasty or acetabular rim trimming may be performed as indicated. Postoperative workflow includes recovery from anesthesia, regional nerve block or multimodal analgesia, discharge instructions, weight-bearing and physical therapy plan, and follow-up for wound check and rehabilitation progression.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |