CPT code 29805: Shoulder arthroscopy, diagnostic examination2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $450.63 for 29805 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 29805 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 29805 covers

The surgeon inserts an arthroscope through small incisions to inspect the shoulder joint, including its cartilage, labrum, and synovium. A synovial biopsy may be taken during the examination. Orthopedic surgeons typically perform this service in an operating room or ambulatory surgery center when examination and imaging have not established the cause of intra-articular symptoms. The work is diagnostic; procedures that treat a finding, such as removing a loose body or repairing a lesion, are reported under the applicable surgical code instead.

Report 29805 when the operative record supports a diagnostic arthroscopic examination, whether or not a synovial biopsy is obtained. Document the shoulder examined, the structures inspected, findings, and any biopsy. If a surgical arthroscopy is performed on the same shoulder during the session, the diagnostic examination is included rather than separately reported. This code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 29805

Across 109 of 109 payment localities, the facility rate for 29805 runs from $399.40 in Arkansas to $545.51 in San Benito County, CA. Puerto Rico pays $450.63. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

29805 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 29805 in every payment locality

How the 29805 rate is calculated

Each of 29805’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 29805

29805 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

Codes related to 29805

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 29805 has changed in Puerto Rico

Price 29805 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates