How much does Medicare pay for CPT 29823?

Medicare allowed an average of $290.14 per service and paid $230.94 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4401.37, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 29823?

Removal of extensive shoulder joint tissue using an endoscope. It was billed 38,108 times to 37,682 Medicare beneficiaries by 1,743 providers in 2024.

Does 29823 pay differently in an office than a hospital?

Yes. The allowed amount averaged $138.57 in an office setting and $292.73 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 29823 most?

Orthopedic Surgery, with 17,178 services from 817 clinicians. Next are Ambulatory Surgical Center, Physician Assistant, Sports Medicine.

CPT 29823

Removal of extensive shoulder joint tissue using an endoscope

$290.14Medicare-allowed amount per service, averaged across 38,108 services

Providers submitted

$4401.37

Asking price, not received

Medicare allowed

$290.14

The fee schedule figure

Medicare paid

$230.94

Balance is patient coinsurance

Providers submitted an average of $4401.37 for this code and Medicare allowed $290.14 — 15.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $230.94 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $138.57
Hospital / facility: $292.73

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 640 services were billed in an office setting and 37,468 in a facility.

Services: 38,108
Beneficiaries: 37,682
Providers billing it: 1,743
Total allowed: $11,056,655

What Medicare pays for CPT 29823

Across 38,108 services billed by 1,743 providers to 37,682 beneficiaries, Medicare allowed an average of $290.14 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 29823

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	17,178	16,958	$169.92	817
Ambulatory Surgical Center	9,076	8,996	$828.48	346
Physician Assistant	8,394	8,309	$23.16	416
Sports Medicine	1,828	1,807	$164.20	83
Nurse Practitioner	1,062	1,047	$21.15	50
Hand Surgery	433	432	$208.77	27
Certified Clinical Nurse Specialist	86	83	$21.64	1
General Surgery	23	22	$32.12	1
Emergency Medicine	16	16	$227.37	1
Osteopathic Manipulative Medicine	12	12	$390.02	1

29823 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	4,400	$357.66	$216.08	191
Florida	3,896	$284.04	$211.40	143
Texas	2,439	$188.97	$129.46	112
North Carolina	1,669	$301.93	$231.02	66
Maryland	1,452	$301.75	$219.52	63
Massachusetts	1,342	$257.29	$170.27	59
Virginia	1,285	$281.15	$209.52	57
South Carolina	1,276	$214.04	$157.86	62
Illinois	1,254	$289.62	$206.37	59
New York	1,249	$344.84	$231.54	74
Nevada	1,163	$295.34	$215.66	38
Pennsylvania	1,150	$288.55	$218.97	61
Arizona	1,068	$270.73	$199.06	51
Ohio	1,023	$322.75	$253.50	52
Tennessee	925	$407.99	$334.78	43
Alabama	867	$225.27	$182.05	25
Georgia	833	$367.59	$284.57	49
Washington	765	$403.83	$294.79	43
New Jersey	740	$240.89	$159.96	36
Colorado	717	$345.69	$255.88	41
Missouri	694	$311.72	$248.92	25
Michigan	677	$247.14	$182.50	31
Indiana	674	$280.88	$213.24	38
Oklahoma	515	$168.66	$116.54	22
New Hampshire	439	$275.12	$195.19	20
Arkansas	432	$242.89	$189.80	15
Iowa	403	$197.87	$147.41	20
Kansas	397	$207.51	$150.51	21
Delaware	378	$363.68	$269.31	18
Louisiana	357	$292.87	$241.85	20
Mississippi	356	$259.96	$212.38	19
Oregon	348	$383.65	$279.56	17
Idaho	346	$148.06	$99.59	17
Montana	310	$198.74	$142.16	14
Connecticut	306	$370.16	$258.99	15
Nebraska	276	$286.13	$217.55	16
North Dakota	238	$219.99	$166.84	10
Kentucky	227	$193.85	$133.73	11
Utah	209	$346.10	$270.87	14
Minnesota	161	$381.61	$286.00	10
Wisconsin	149	$248.24	$181.84	11
Rhode Island	137	$412.24	$304.93	5
Hawaii	101	$129.57	$64.42	4
Maine	101	$140.39	$78.72	4
South Dakota	84	$132.73	$81.56	5
New Mexico	84	$422.79	$336.99	3
West Virginia	57	$295.81	$235.45	4
District of Columbia	48	$310.96	$195.58	3
Wyoming	47	$426.86	$333.74	3
Vermont	23	$68.57	$28.83	2
Alaska	21	$921.88	$680.41	1

Related codes

29827Repair of shoulder rotator cuff$1315.10
29848Release of wrist ligament$567.21
29826Shaving of part of shoulder bone and repair of ligament$117.20
29824Partial removal of collar bone at shoulder$399.85
29828Release of tendon connecting biceps muscle and shoulder$1244.67
29881Removal of knee cartilage$1040.58
29880Removal of both knee cartilages$1020.13
29879Repair of knee joint$618.02
29876Removal of joint lining from multiple knee joint compartments$605.32
29822Limited removal of abnormal shoulder joint tissue$411.36

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.