CPT Code Overview

CPT 29824 describes a surgical shoulder arthroscopy procedure: distal claviculectomy including distal articular surface (Mumford procedure). This procedure involves arthroscopic removal of the distal end of the clavicle to address pain and dysfunction related to acromioclavicular joint pathology.

Service type: Surgical procedure on the musculoskeletal system (shoulder arthroscopy)

Typical site of service: Outpatient Hospital (POS 22)

Clinical Context

A 52-year-old patient presents to the orthopaedic clinic with months of progressive shoulder pain, localized to the acromioclavicular region and worsened by overhead activity. Conservative care including physical therapy, NSAIDs, and a corticosteroid injection provided limited relief. Imaging (radiographs and MRI) demonstrates distal clavicular osteoarthritis with impingement changes and a possible concomitant rotator cuff partial-thickness tear. The surgical plan is an arthroscopic distal claviculectomy (Mumford procedure) to remove the symptomatic distal clavicle and resect the articular surface, performed in an outpatient hospital setting (POS 22) under general anesthesia with regional block as indicated. The typical workflow includes preoperative evaluation and history/physical, anesthesia assessment, operative arthroscopy with distal claviculectomy, intraoperative documentation of side laterality, immediate postoperative recovery, and standard postoperative instructions and follow-up for rehabilitation.

Coding Specifications

• Common Modifiers

• RT: Used when the procedure is performed on the right shoulder.

• LT: Used when the procedure is performed on the left shoulder.

• 59: Used to indicate a Distinct Procedural Service when another procedure or service is performed on the same day that is not typically bundled with the primary procedure and meets the definition of a separate service.

• 51: Used to indicate Multiple Procedures were performed during the same operative session when more than one distinct procedure is billed by the same provider.

• Provider Taxonomies

• Notes on application

• Use RT or LT to indicate laterality in the operative report and claim.

• Use 59 when documentation supports that an additional procedure is separate and distinct from the distal claviculectomy and is not inherently included with 29824.

• Use 51 when multiple distinct procedures are reported together in the same operative session; follow payer-specific bundling rules for multiple surgeries.

Related Diagnoses

• M19.011 — Primary osteoarthritis, right shoulder

Primary degenerative joint disease of the right acromioclavicular or glenohumeral joint that can produce pain and functional limitation leading to a distal claviculectomy when the distal clavicle articular surface is a pain generator.

• M19.012 — Primary osteoarthritis, left shoulder

Primary degenerative joint disease of the left shoulder; clinical relevance mirrors the right-sided code when surgery targets the left distal clavicle.

• M75.101 — Unspecified rotator cuff tear or rupture of right shoulder

Represents rotator cuff pathology on the right that may coexist with acromioclavicular degenerative changes; operative decision-making may include distal claviculectomy with or without concomitant rotator cuff procedures.

• M75.102 — Unspecified rotator cuff tear or rupture of left shoulder

Represents rotator cuff pathology on the left with similar clinical relevance for combined shoulder arthroscopy procedures.

• S43.401A — Sprain of unspecified acromioclavicular joint, initial encounter

Acute acromioclavicular sprain may cause persistent pain or instability of the distal clavicle and be an indication for distal claviculectomy if conservative care fails.

Related CPT Codes

• Relationship to 29824:

• 29826: Often performed in the same arthroscopic shoulder session when subacromial impingement or acromial spurs coexist with distal clavicular pathology; payer guidance notes this code may be listed separately in addition to the primary procedure when appropriate.

• 29827: Performed when an arthroscopic rotator cuff repair is required; this is a more extensive reconstruction than a distal claviculectomy and may be billed in the same session when both procedures are documented.

• 29828: Biceps tenodesis may be performed during the same arthroscopic shoulder surgery when biceps pathology is identified; documentation must support medical necessity for concurrent procedures.

• Common usage: 29826, 29827, and 29828 can be reported together with 29824 when each procedure is separately identifiable and supported by operative documentation; payer-specific bundling and modifier rules apply.

National commercial mean rates exceed Medicare for CPT 29824. The BUCA composite mean ($868.19) is higher than the Medicare mean ($652.23) by $215.96, indicating materially higher allowed amounts across commercial markets compared with the Medicare program.

Dispersion measured as the interquartile range (P75 − P25) varies by payer. UnitedHealth Group shows the widest spread (IQR = $712.00), followed by Cigna (IQR = $644.00) and Blue Cross Blue Shield (IQR = $367.49). Aetna has a narrower spread (IQR = $332.00) and Medicare is the tightest (IQR = $59.00). The table and chart below present the full payer breakdown.