Summary & Overview
CPT 29881: Arthroscopic Knee Surgery with Meniscectomy
CPT code 29881 is a widely utilized billing code for arthroscopic knee surgery involving meniscectomy of either the medial or lateral meniscus. This procedure is a cornerstone in orthopedic surgery, addressing meniscal tears and derangements that impact knee function and patient quality of life. The code is relevant for outpatient hospital settings, where minimally invasive techniques are preferred for faster recovery and reduced complications.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, provide coverage for this procedure, making it a significant focus for policy and reimbursement analysis. Readers will gain insight into clinical indications, typical sites of service, and the procedural context for CPT 29881. The publication also covers related codes, common modifiers, and associated diagnoses, offering a comprehensive overview for stakeholders in orthopedic surgery and medical billing.
Key benchmarks, policy updates, and clinical context are discussed to inform providers, payers, and analysts about current trends and requirements for arthroscopic meniscectomy. The summary highlights the importance of understanding payer coverage, coding nuances, and clinical relevance to ensure accurate billing and compliance in orthopedic practice.
CPT Code Overview
CPT 29881 describes a surgical arthroscopy of the knee, specifically involving a meniscectomy of either the medial or lateral meniscus, including any meniscal shaving. This procedure is commonly performed by orthopedic surgeons to address meniscal injuries or derangements, and is typically conducted in an outpatient hospital setting (Place of Service 22). The service type is classified as Orthopedic Surgery, reflecting its role in treating knee joint conditions and improving patient mobility and function.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting with knee pain, swelling, or mechanical symptoms such as locking or catching. The patient may have a history of a meniscal tear, either from a previous injury or degenerative changes. After clinical evaluation and imaging (such as MRI), the orthopedic surgeon determines that arthroscopic meniscectomy is indicated. The procedure is performed in an outpatient hospital setting, where the surgeon uses arthroscopy to remove or shave the damaged portion of the meniscus (either medial or lateral). Postoperative care includes physical therapy and follow-up to monitor recovery and knee function.
Coding Specifications
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Modifiers:
Modifier Code Description Usage RTRight side Used when the procedure is performed on the right knee LTLeft side Used when the procedure is performed on the left knee 59Distinct Procedural Service Used to indicate a separate and distinct procedure from others performed on the same day 51Multiple Procedures Used when multiple procedures are performed during the same operative session -
Provider Taxonomies:
Taxonomy Code Specialty 207X00000XOrthopaedic Surgery 207XX0004XOrthopaedic Surgery of the Spine 207XS0117XOrthopaedic Surgery Sports Medicine 207XX0801XOrthopaedic Trauma
These taxonomies represent providers specializing in orthopedic surgery, including subspecialties such as sports medicine, trauma, and spine surgery.
Related Diagnoses
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M23.2- Derangement of meniscus due to old tear or injury- Indicates chronic meniscal damage, often leading to the need for meniscectomy.
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M23.3- Other meniscus derangements- Covers other types of meniscal abnormalities that may require surgical intervention.
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M23.8- Other internal derangements of knee- Refers to internal knee issues, such as ligament or cartilage problems, which may coexist with meniscal tears.
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M17.11- Unilateral primary osteoarthritis, right knee- Osteoarthritis can cause or be associated with meniscal damage, especially in the right knee.
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M17.12- Unilateral primary osteoarthritis, left knee- Osteoarthritis can cause or be associated with meniscal damage, especially in the left knee.
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S83.241A- Other tear of medial meniscus, current injury, right knee, initial encounter- Represents an acute medial meniscus tear in the right knee, often treated with arthroscopic meniscectomy.
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S83.242A- Other tear of medial meniscus, current injury, left knee, initial encounter- Represents an acute medial meniscus tear in the left knee, often treated with arthroscopic meniscectomy.
Related CPT Codes
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29880- Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)- Used when both medial and lateral meniscectomy are performed during the same procedure. It is an alternative to
29881when both compartments are treated.
- Used when both medial and lateral meniscectomy are performed during the same procedure. It is an alternative to
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29877- Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)- Often performed in conjunction with meniscectomy to address cartilage damage. Can be billed separately with appropriate modifiers.
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29876- Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments- Used when synovectomy is performed in addition to meniscectomy, involving two or more compartments of the knee.
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29882- Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)- Used when the meniscus is repaired rather than removed. May be an alternative or performed in addition to
29881if both repair and meniscectomy are needed.
- Used when the meniscus is repaired rather than removed. May be an alternative or performed in addition to
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29875- Arthroscopy, knee, diagnostic, with or without synovial biopsy- Used for diagnostic arthroscopy, often preceding surgical intervention. Not commonly billed with
29881unless a separate diagnostic procedure is performed.
- Used for diagnostic arthroscopy, often preceding surgical intervention. Not commonly billed with
National Reimbursement Benchmarks
National mean rates for CPT code 29881 show that Medicare reimbursement ($526.77) is significantly lower than the average commercial rate represented by BUCA ($770.20). Commercial payers such as UnitedHealth Group ($995.71) and Cigna ($932.82) offer the highest mean rates, while Aetna ($639.40) is closer to Medicare but still notably higher.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies across payers. Medicare has the tightest range ($47.00), indicating more consistent rates, while UnitedHealth Group exhibits the widest spread ($555.33), reflecting greater variability in commercial reimbursement. Cigna and BCBS also show substantial dispersion, with ranges of $530.00 and $326.30, respectively. Aetna and BUCA have moderate ranges of $309.50 and $370.31.
The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.