How much does Medicare pay for CPT 29826?

Medicare allowed an average of $117.20 per service and paid $93.47 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1682.46, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 29826?

Shaving of part of shoulder bone and repair of ligament using an endoscope. It was billed 52,226 times to 51,790 Medicare beneficiaries by 2,478 providers in 2024.

Does 29826 pay differently in an office than a hospital?

Yes. The allowed amount averaged $132.39 in an office setting and $116.88 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 29826 most?

Orthopedic Surgery, with 31,662 services from 1,475 clinicians. Next are Physician Assistant, Sports Medicine, Nurse Practitioner.

CPT 29826

Shaving of part of shoulder bone and repair of ligament using an endoscope

$117.20Medicare-allowed amount per service, averaged across 52,226 services

Providers submitted

$1682.46

Asking price, not received

Medicare allowed

$117.20

The fee schedule figure

Medicare paid

$93.47

Balance is patient coinsurance

Providers submitted an average of $1682.46 for this code and Medicare allowed $117.20 — 14.4× 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 $93.47 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $132.39
Hospital / facility: $116.88

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,085 services were billed in an office setting and 51,141 in a facility.

Services: 52,226
Beneficiaries: 51,790
Providers billing it: 2,478
Total allowed: $6,120,887

What Medicare pays for CPT 29826

Across 52,226 services billed by 2,478 providers to 51,790 beneficiaries, Medicare allowed an average of $117.20 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 29826

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	31,662	31,379	$162.02	1,475
Physician Assistant	14,847	14,748	$22.53	723
Sports Medicine	2,835	2,809	$162.57	137
Nurse Practitioner	1,842	1,823	$22.06	89
Hand Surgery	894	888	$164.71	49
Certified Clinical Nurse Specialist	88	86	$22.31	2
Osteopathic Manipulative Medicine	33	32	$161.07	2
General Surgery	25	25	$28.14	1

29826 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
Florida	5,009	$121.38	$92.31	192
California	4,023	$127.54	$99.06	184
Texas	3,893	$115.34	$93.89	178
North Carolina	2,443	$108.17	$90.70	115
Virginia	2,116	$116.88	$96.31	84
Pennsylvania	1,744	$117.29	$94.50	95
South Carolina	1,707	$117.91	$98.44	79
Illinois	1,650	$125.06	$94.83	83
New York	1,591	$145.59	$104.97	92
Arizona	1,549	$103.30	$84.89	72
Alabama	1,479	$97.23	$86.28	70
Ohio	1,463	$115.03	$94.55	80
Massachusetts	1,455	$126.03	$97.71	67
Tennessee	1,285	$121.48	$106.78	66
Oklahoma	1,275	$122.40	$104.54	61
Georgia	1,236	$130.47	$104.71	69
Colorado	1,202	$113.14	$90.91	58
Maryland	1,076	$126.72	$96.85	46
Michigan	1,075	$110.68	$86.10	53
Kansas	1,038	$102.19	$88.60	37
Missouri	1,028	$109.49	$91.29	50
Nevada	997	$110.73	$89.87	38
Washington	958	$124.55	$102.81	49
Mississippi	955	$126.79	$108.68	43
Utah	893	$106.97	$88.23	46
New Jersey	853	$119.53	$87.93	48
Arkansas	713	$114.78	$100.05	34
Nebraska	701	$95.21	$84.04	32
Indiana	651	$102.71	$90.11	38
South Dakota	609	$91.37	$79.54	31
Montana	604	$92.32	$74.02	22
Kentucky	555	$119.30	$100.24	23
Wisconsin	495	$110.77	$96.54	36
Iowa	491	$106.87	$92.68	27
Oregon	449	$111.26	$94.08	22
Louisiana	404	$103.40	$87.36	18
Idaho	354	$107.98	$93.93	20
New Hampshire	305	$113.10	$89.50	11
Delaware	297	$117.27	$95.31	14
Minnesota	293	$117.84	$101.15	21
Connecticut	268	$131.88	$100.70	16
Wyoming	179	$113.09	$92.99	11
North Dakota	156	$107.97	$91.57	10
New Mexico	142	$146.06	$121.09	7
Alaska	116	$167.77	$118.11	5
Maine	98	$126.64	$105.37	7
West Virginia	93	$140.04	$110.24	5
Hawaii	89	$162.86	$133.37	3
Rhode Island	76	$126.26	$99.29	4
Vermont	59	$87.51	$77.14	4
District of Columbia	36	$192.51	$132.86	2

Related codes

29827Repair of shoulder rotator cuff$1315.10
29848Release of wrist ligament$567.21
29823Removal of extensive shoulder joint tissue$290.14
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.