How much does Medicare pay for CPT 29828?

Medicare allowed an average of $1244.67 per service and paid $991.52 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $6685.12, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 29828?

Release of tendon connecting biceps muscle and shoulder using an endoscope. It was billed 21,828 times to 21,707 Medicare beneficiaries by 1,107 providers in 2024.

Does 29828 pay differently in an office than a hospital?

Yes. The allowed amount averaged $373.25 in an office setting and $1263.14 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 29828 most?

Orthopedic Surgery, with 9,070 services from 485 clinicians. Next are Ambulatory Surgical Center, Physician Assistant, Sports Medicine.

CPT 29828

Release of tendon connecting biceps muscle and shoulder using an endoscope

$1244.67Medicare-allowed amount per service, averaged across 21,828 services

Providers submitted

$6685.12

Asking price, not received

Medicare allowed

$1244.67

The fee schedule figure

Medicare paid

$991.52

Balance is patient coinsurance

Providers submitted an average of $6685.12 for this code and Medicare allowed $1244.67 — 5.4× 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 $991.52 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $373.25
Hospital / facility: $1263.14

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 453 services were billed in an office setting and 21,375 in a facility.

Services: 21,828
Beneficiaries: 21,707
Providers billing it: 1,107
Total allowed: $27,168,657

What Medicare pays for CPT 29828

Across 21,828 services billed by 1,107 providers to 21,707 beneficiaries, Medicare allowed an average of $1244.67 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 29828

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	9,070	9,012	$485.09	485
Ambulatory Surgical Center	6,778	6,744	$3229.87	285
Physician Assistant	4,270	4,248	$66.92	242
Sports Medicine	964	960	$487.34	53
Nurse Practitioner	552	549	$68.04	30
Hand Surgery	160	160	$507.60	11
General Surgery	34	34	$76.22	1

29828 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	2,024	$1666.86	$1067.60	99
Florida	1,724	$1168.92	$903.52	82
North Carolina	1,350	$1221.87	$992.57	56
Texas	1,152	$1288.43	$1001.90	66
Virginia	1,142	$1243.88	$984.82	47
South Carolina	805	$900.63	$710.99	40
Tennessee	718	$1610.76	$1400.18	32
Missouri	704	$1245.39	$1028.09	29
Ohio	691	$1006.54	$786.29	39
Illinois	664	$1371.25	$1008.37	41
Georgia	642	$1291.63	$994.89	39
Mississippi	630	$1371.24	$1211.82	20
Colorado	603	$1300.46	$993.29	29
Pennsylvania	567	$1142.93	$841.75	36
Massachusetts	523	$1058.79	$738.28	29
Washington	520	$1674.06	$1248.53	26
Arizona	493	$1514.40	$1192.50	29
Kansas	491	$598.98	$437.07	22
Utah	488	$1410.20	$1137.50	24
Maryland	488	$1278.07	$958.94	26
New York	475	$1754.73	$1233.58	26
Oregon	448	$1346.26	$960.53	21
Michigan	408	$1439.41	$1211.72	21
Alabama	397	$868.44	$737.73	22
Oklahoma	376	$732.20	$560.01	19
New Jersey	335	$981.82	$688.91	19
Louisiana	319	$720.19	$559.42	18
Nevada	281	$1467.08	$1102.05	13
Kentucky	238	$913.44	$699.87	14
Arkansas	233	$838.77	$666.41	11
Montana	224	$1066.36	$822.58	10
Connecticut	224	$1446.36	$1003.21	12
Indiana	176	$1398.75	$1116.56	9
South Dakota	167	$267.08	$140.97	10
Iowa	162	$1139.79	$937.86	10
Wisconsin	116	$998.59	$758.98	9
Nebraska	115	$281.46	$133.06	7
Minnesota	112	$1815.69	$1413.66	8
North Dakota	112	$658.52	$480.94	4
Idaho	102	$300.10	$176.80	7
Wyoming	82	$793.41	$582.31	6
Alaska	69	$1222.10	$906.23	4
Hawaii	42	$1656.06	$1062.31	3
Delaware	40	$1581.98	$1137.45	3
District of Columbia	38	$1876.01	$1352.04	2
New Hampshire	33	$1404.67	$1098.35	2
West Virginia	32	$404.66	$224.38	2
Rhode Island	24	$469.69	$247.50	2
New Mexico	17	$474.03	$227.68	1
Maine	12	$410.40	$175.51	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
29823Removal of extensive shoulder joint tissue$290.14
29824Partial removal of collar bone at shoulder$399.85
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.