CPT code 29821: Shoulder arthroscopy, complete synovectomy2026 Medicare rate & RVUs in Missouri
Reports arthroscopic removal of synovial tissue throughout the shoulder joint when disease requires a complete rather than partial synovectomy.
CMS doesn’t publish an office rate for 29821 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 29821 covers
An orthopedic surgeon performs this procedure through small shoulder incisions using an arthroscope and instruments to remove diseased synovial tissue throughout the operative joint. It may be used for substantial synovial inflammation, including in a shoulder affected by inflammatory arthritis. The work is therapeutic, not merely inspection or biopsy, and is commonly performed in a hospital outpatient department or ambulatory surgery center.
Choose this code when the documented arthroscopic synovectomy is complete; limited removal belongs to the partial-synovectomy level. The operative report should describe the affected synovium, the extent of excision, and the therapeutic work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When related endoscopies are performed together, endoscopy-family pricing applies. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires 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.
Where 29821 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $541.08 |
| Metropolitan St. Louis, MO | Unavailable | $545.60 |
| Rest of Missouri | Unavailable | $521.74 |
How the 29821 rate is calculated
Each of 29821’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.
How the rate is built · 29821
RVUs × geographic indexes × conversion factor
Work7.69
7.69 RVUs× 1.000 GPCI
Practice expense7.46
7.46 RVUs× 1.000 GPCI
Malpractice1.54
1.54 RVUs× 1.000 GPCI
Adjusted RVUs
16.6900
Conversion factor
$33.4009
Medicare rate
$557.46
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 29821
29821 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 29821
Shoulder arthroscopy, complete synovectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 29821
Shoulder arthroscopy, complete synovectomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
29821 without 50 · national facility
$557.46
Shoulder arthroscopy, complete synovectomy
29821-50 · Bilateral: 150%
$836.19
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
29821 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 29820Shoulder synovectomyPartial, arthroscopic
- This code represents complete synovectomy; 29820 represents partial synovectomy. Base the choice on the documented extent of synovial removal.
- 29805Shoulder arthroscopyDiagnostic examination
- 29805 is diagnostic shoulder arthroscopy, with or without synovial biopsy. This code describes therapeutic complete synovectomy.
- 29822Shoulder debridementLimited, one or two structures
- 29822 describes limited arthroscopic debridement, not complete synovial excision. Report the procedure that matches the documented tissue work.
- 29823Arthroscopic debridementExtensive, three or more structures
- 29823 describes extensive arthroscopic debridement. It is distinct from complete synovectomy, which targets removal of synovial tissue.
29821 billing questions
How do I distinguish this from 29820?
Use 29821 for a complete shoulder synovectomy and 29820 when the documented synovectomy is partial. The operative report should establish the extent of synovial tissue removal.
Can diagnostic arthroscopy be reported separately?
The therapeutic synovectomy is the service represented here. A diagnostic inspection performed as part of that operative work should not be treated as a separate diagnostic procedure.
What documentation supports complete synovectomy?
Document the synovial disease, the shoulder joint treated, and the extent of synovial removal. The record should support complete rather than limited or partial excision.
How is bilateral surgery reported?
For procedures on both shoulders, report modifier 50; CMS pays bilateral procedures at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
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