CPT 29806
Global 090 ActiveSho arthrs srg capsulorraphy
CPT 29806 Billing & Documentation Guide
CPT code 29806 (Sho arthrs srg capsulorraphy) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 14.76, a non-facility practice expense RVU of 11.35, and a malpractice RVU of 3.02, a total non-facility RVU of 29.13 and facility RVU of 29.13. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $985.06, though rates vary from $870.59 to $1198.82 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 29806, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 29806 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 29806 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 29806
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 14.76 | 14.76 |
| Practice Expense RVU | 11.35 | 11.35 |
| Malpractice RVU | 3.02 | 3.02 |
| Total RVU | 29.13 | 29.13 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 29806
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $1013.95 | $1013.95 | $970.94 - $1147.96 | 29 |
| Florida | $1069.72 | $1069.72 | $1007.03 - $1142.74 | 3 |
| Georgia | $976.09 | $976.09 | $951.39 - $1000.79 | 2 |
| Illinois | $1053.79 | $1053.79 | $996.78 - $1108.94 | 4 |
| Michigan | $990.95 | $990.95 | $953 - $1028.9 | 2 |
| North Carolina | $911.15 | $911.15 | $911.15 - $911.15 | 1 |
| New York | $1076.43 | $1076.43 | $924.05 - $1162.62 | 5 |
| Ohio | $940.79 | $940.79 | $940.79 - $940.79 | 1 |
| Pennsylvania | $976.59 | $976.59 | $936.33 - $1016.85 | 2 |
| Texas | $962.63 | $962.63 | $931.69 - $1012.19 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 29806
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 29806 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0566T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 29806
What does CPT code 29806 mean? +
CPT code 29806 represents: Sho arthrs srg capsulorraphy. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 29806? +
The 2026 Medicare national average non-facility payment for CPT 29806 is $985.06. Rates range from $870.59 to $1198.82 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 29806? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 29806? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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