CPT code 29866: Cartilage restoration, autologous osteochondral graft2026 Medicare rate & RVUs in Missouri
Reports arthroscopic transfer of the patient's own osteochondral graft to treat a focal knee cartilage defect, including harvesting the graft.
CMS doesn’t publish an office rate for 29866 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 29866 covers
This procedure transfers one or more plugs of the patient’s own bone and cartilage from a donor area of the knee to a focal cartilage defect, using arthroscopy. It is used for selected osteochondral lesions where replacing the damaged surface with the patient’s own tissue is appropriate. An orthopedic surgeon typically performs it in an operating room, most often in a hospital outpatient or ambulatory surgery setting. The graft harvest is part of the service.
Report the code when the operative documentation supports arthroscopic autograft transfer, rather than a different cartilage-restoration method or an allograft. Documentation should identify the defect, the autograft transfer, and the arthroscopic approach. CMS assigns 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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 29866 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 | $952.57 |
| Metropolitan St. Louis, MO | Unavailable | $960.31 |
| Rest of Missouri | Unavailable | $921.45 |
How the 29866 rate is calculated
Each of 29866’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 · 29866
RVUs × geographic indexes × conversion factor
Work14.30
14.30 RVUs× 1.000 GPCI
Practice expense11.98
11.98 RVUs× 1.000 GPCI
Malpractice3.04
3.04 RVUs× 1.000 GPCI
Adjusted RVUs
29.3200
Conversion factor
$33.4009
Medicare rate
$979.31
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 29866
29866 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 29866
Cartilage restoration, autologous osteochondral graft
| 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 | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 29866
Cartilage restoration, autologous osteochondral graft
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
29866 without 50 · national facility
$979.31
Cartilage restoration, autologous osteochondral graft
29866-50 · Bilateral: 150%
$1,468.97
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).
29866 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 29867Knee allograftArthroscopic osteochondral implantation
- Use 29866 for arthroscopic transfer of the patient’s own osteochondral tissue. Use 29867 for arthroscopic implantation of donor allograft tissue.
- 29879Arthroscopic cartilage procedureAbrasion or microfracture
- 29879 describes abrasion arthroplasty, not transfer of an osteochondral plug. Select based on the technique documented in the operative report.
- 27412Cartilage implantationAutologous chondrocytes
- 27412 describes autologous chondrocyte implantation, a distinct cartilage-restoration procedure. It is not the arthroscopic transfer of osteochondral autograft plugs reported with 29866.
29866 billing questions
How does this differ from 29867?
29866 is for transfer of the patient’s own osteochondral tissue. 29867 describes arthroscopic implantation of an osteochondral allograft.
Is harvesting the graft separately reportable?
The graft harvest is included in 29866. The code covers arthroscopic autograft transfer, including obtaining the graft.
How is 29866 different from 29879?
29866 transfers osteochondral autograft tissue to a defect. 29879 is used for abrasion arthroplasty, a different cartilage-treatment technique.
What documentation supports reporting 29866?
The operative report should identify the focal defect, arthroscopic approach, and transfer of the patient’s own osteochondral graft. It should distinguish autograft transfer from allograft implantation or another cartilage procedure.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or another surgeon be paid for this case?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeon or team-surgery payment for this code.
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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