Brief Guide to CPT Code 29827

Medical Codes
December 12, 2025

Confused about billing for complex shoulder repairs that utilize an arthroscopic approach? Orthopedic coders and billers often find the guidelines surrounding shoulder surgery codes, especially those involving multiple repairs, to be a significant challenge.

That’s why our experts have created this guide.

In this guide, we will discuss CPT code 29827, one of the most important surgical codes for orthopedic practices. By the end of this article, we aim to clear all doubts surrounding this code, helping your practice maximize compliance and reimbursement.

CPT Code 29827 Description

CPT code 29827 is defined as:

“Arthroscopy, shoulder, surgical, with rotator cuff repair.”

As evident from the definition, 29827 is a surgical CPT code used to report a minimally invasive procedure performed in the operating room. This code specifically covers the repair of one or more torn tendons within the rotator cuff (Supraspinatus, Infraspinatus, Teres Minor, Subscapularis) using an arthroscope (small camera) and specialized instruments inserted through small incisions.

Key Characteristics of CPT Code 29827

Approach: Must be performed via an arthroscopic (minimally invasive) approach. If an open or mini-open repair is performed, a different CPT code (e.g., 23412) should be used.
Inclusions: CPT code 29827 represents the entire surgical effort to repair the rotator cuff, regardless of whether one, two, or all four tendons are repaired.
Bundled Services: The work of diagnostic arthroscopy of the shoulder (CPT 29805), as well as any limited debridement (CPT 29822) required to perform the primary repair, is generally bundled into the global service of 29827 and should not be billed separately.
Global Period: This code carries a 90-day global period, meaning all routine pre-operative, intra-operative, and most post-operative care related to the surgery is included in the payment for the code.

Scenarios Where CPT Code 29827 is Applicable

The primary use of CPT code 29827 is for the arthroscopic repair of a torn rotator cuff. However, its usage often occurs alongside other procedures.

1. Simple Arthroscopic Rotator Cuff Repair

Suppose a 55-year-old patient who sustained a fall presents with chronic, debilitating pain and weakness in the left shoulder. An MRI confirms a full-thickness tear of the supraspinatus tendon (a component of the rotator cuff).

The orthopedic surgeon performs a surgical shoulder arthroscopy to visualize the joint and successfully repair the torn supraspinatus tendon by suturing it back to the bone. During the procedure, the surgeon also performs limited debridement of the frayed edges of the tear to facilitate the repair.

Coding: The entire surgical procedure is reported using CPT code 29827 with the LT (Left Side) modifier. The limited debridement is considered inclusive and is not billed separately.

2. Rotator Cuff Repair with Biceps Tenodesis

Consider an athlete with a massive rotator cuff tear (Supraspinatus and Infraspinatus) who also has a concomitant pathology of the long head of the biceps tendon. The surgeon determines that an arthroscopic repair of the rotator cuff is needed, in addition to an arthroscopic biceps tenodesis (reattachment of the biceps tendon).

Coding:

CPT 29827 (Arthroscopic rotator cuff repair)
CPT 29828 (Arthroscopy, shoulder, surgical; biceps tenodesis)

In this case, since CPT 29827 and CPT 29828 are distinct procedures performed on separate structures, they are typically separately reportable. A separate modifier (e.g., 51 for multiple procedures, though often deleted by Medicare) or a site-specific modifier (RT/LT) may be required depending on the payer.

Applicable Modifiers for CPT Code 29827

Proper modifier application is critical for preventing claim denials, especially when 29827 is billed with other arthroscopic shoulder procedures.

Modifier	Description	Usage Context for 29827
RT/LT	Right Side / Left Side	Required to specify the limb on which the procedure was performed. (e.g., 29827-RT).
50	Bilateral Procedure	Used if the procedure is performed on both shoulders during the same operative session. (Check payer guidelines, as some prefer two line items with RT/LT).
51	Multiple Procedures	May be required by some commercial payers when 29827 is performed with another major procedure (e.g., 29828, 29824) during the same session.
59	Distinct Procedural Service	Generally inappropriate to use for simple bundled services (like limited debridement) in the same shoulder as 29827, but may be necessary to bypass an edit when a service is performed on a truly distinct structure in the same shoulder.
22	Increased Procedural Services	Used when the procedure involves significantly greater complexity or time than usual (e.g., massive, chronic tear requiring an extended surgery and multiple suture anchors). Requires extensive supporting documentation.

Note: Shoulder surgery coding is highly complex. Procedures often reported alongside 29827, such as subacromial decompression (+29826), are often billed as add-on codes or may be subject to strict National Correct Coding Initiative (NCCI) edits regarding unbundling. Always verify with current NCCI guidelines.

CPT Code 29827 Billing & Reimbursement Guidelines

Overlooking specific documentation and coding requirements for complex surgical procedures like CPT 29827 is a leading cause of audit risk and denial.

Provide Detailed Documentation (Operative Report)

For proper reimbursement and audit defense, the operative report must clearly and explicitly support the use of CPT 29827:

Surgical Approach: State that the procedure was performed arthroscopically.
Tear Details: Describe the size, location, and type of the rotator cuff tear (e.g., “full-thickness, retracted supraspinatus tear”).
Repair Method: Document the technique used (e.g., “suture anchor fixation,” “single-row vs. double-row repair”).
Concomitant Procedures: Clearly itemize and describe any other procedures performed (e.g., biceps tenodesis, acromioplasty) to justify separate billing. Crucially, if debridement (CPT 29823) is billed separately, the documentation must show that the debridement was extensive and on structures distinct from those being repaired.

Understand NCCI Bundling Edits

Many procedures performed during shoulder arthroscopy are bundled into the primary procedure (29827). Coders must be vigilant about NCCI rules to avoid billing for non-separately payable components.

Diagnostic Arthroscopy (29805): Always bundled when followed by a surgical procedure (29827) in the same joint.
Limited Debridement (29822): Usually bundled into 29827.
Subacromial Decompression (Add-on Code +29826): This is an add-on code that can typically be reported alongside 29827, but only if medically necessary and if the documentation clearly supports the work.

Conclusion

CPT code 29827 is the standard billing code for an arthroscopic rotator cuff repair. Successful reimbursement hinges on accurately defining the procedure, correctly applying anatomical and multiple-procedure modifiers (RT/LT, 51), and ensuring that the operative note provides meticulous detail about the repair and all separately billable procedures.

However, if your orthopedic practice is experiencing a high volume of denials for shoulder arthroscopy claims, the best solution is to outsource your coding and billing to specialized companies. We provide premium orthopedic billing services that ensure compliance with NCCI edits and maximize your revenue cycle integrity.