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CPT · SURGERY

29881

Surgery (CPT® descriptor withheld: AMA licence required)

Reimbursement benchmark

RVU26D
Not priced

National benchmark · GPCI 1.000
Non-facility · Non-QP · per service

CMS marks this place of service as not applicable.. This code must not be treated as a zero-dollar payment.

Behind the number

Each RVU × its geographic practice cost index

Physician work6.850 RVU × 1.000 GPCI—
Practice expense7.190 RVU × 1.000 GPCI—
Malpractice1.400 RVU × 1.000 GPCI—
Conversion factorNon-QP schedule× 33.4009
Estimated fee schedule amountNot priced

Geography makes a difference

Same component, setting, and provider schedule across 109 localities

109 localities

Locality comparisons are unavailable for this component or service date.

Modifiers on this code

National · Facility (only payable setting)

Computed from the CMS payment policy indicators on this code's RVU row, priced in your current context. Where the fee schedule sets no percentage, the row says who decides.

ModifierEffectAmountHow it applies to 29881
25Significant, separately identifiable E/M on the same day
Not applicable
—Modifier 25 belongs on the E/M code billed alongside this procedure, not on this code.
26Professional component
Not applicable
—Physician service only: no professional/technical split exists (PC/TC indicator 0).
TCTechnical component
Not applicable
—Physician service only: no professional/technical split exists (PC/TC indicator 0).
50Bilateral procedure
Fee-schedule rule
$773.57150% of the fee schedule amount when performed bilaterally (bilateral indicator 1).
51Multiple procedures, same session
Payer-determined
—Endoscopy rule: paid at the full amount minus the base endoscopy when billed with another code in the same family (indicator 3).
59 / XE XS XP XUDistinct procedural service
No change
$515.71Does not change the amount. It asks the payer to bypass an NCCI pair, which only works when that pair's modifier indicator is 1; hard-stop pairs (indicator 0) deny regardless. See the NCCI conflicts below.
80 / 81 / 82Assistant surgeon
Payer-determined
—Payment restricted: an assistant is paid only with documentation of medical necessity (indicator 0).
62Two surgeons (co-surgery)
Not applicable
—Co-surgeons are not permitted for this code (indicator 0).
66Surgical team
Not applicable
—Team surgery is not permitted for this code (indicator 0).
95 / 93Telehealth (audio-video / audio-only)
No change
$515.71The fee schedule amount does not change; whether the facility or non-facility rate applies depends on the place of service reported, and whether the service is on the Medicare telehealth list.
22Increased procedural services
Payer-determined
—Carrier-priced. The schedule sets no percentage; the payer decides any increase from the documentation of substantially greater work.
52Reduced services
Payer-determined
—Payer-determined reduction from the fee schedule amount; the schedule sets no percentage.
53Discontinued procedure
Payer-determined
—Payer-determined; documentation must show the procedure was stopped for the patient's wellbeing.
76 / 77Repeat procedure, same or other physician
No change
$515.71Each repeat is paid at the full fee schedule amount when the documentation supports a separate, medically necessary repeat.

Estimates before payer adjustments and cost sharing. A payer's own policy can differ from Medicare's; verify before billing.

Before this code goes on a claim

Denial prevention
Status indicator AActive and separately payable under the physician fee schedule.
70 hard-stop NCCI pairs0 pairs bundle this code into another code and 70 bundle other codes into it, with no modifier override (indicator 0). Billed together on the same date, the column-2 code denies.
215 pairs allow a modifier28 pairs where this is the bundled code and 187 where it is the primary can be unbundled with 59 or X{EPSU} when the documentation shows a distinct service (indicator 1). Check the claim before submission: this code is the one that denies in 28 active pairs.
Global period 09090-day global period. The day before, the day of, and 90 days after are included; unrelated visits need modifier 24 and staged or related procedures need 58.
Place of serviceCMS marks the non-facility setting as not applicable: this code is paid only when performed in a facility.
BilateralBill once with modifier 50, not twice, unless the payer's policy asks for RT/LT on two lines. Two lines without a modifier duplicate-deny.
Assistant surgeonAssistant-at-surgery claims need documentation of medical necessity or they deny.

Field data from billers

Unavailable

Field data is not available right now.

Structured answers only. No patient details, claim numbers or free text are collected.

Code intelligence

CPT
Payment statusActive
Global period090
PC/TC indicator0
Multiple procedure indicator3
Bilateral surgery indicator1
Assistant surgery indicator0

Raw CMS indicators. Read the release documentation before interpreting a payment policy indicator.

CMS release documentation
PUT THE DATA TO WORK

From a rate to an informed decision.

Understand the RVUs, compare a second code, or evaluate an observed allowed amount.

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RVU-based Medicare benchmark, before payer adjustments, OPPS caps, sequestration, and patient cost sharing. An estimate, not a payment guarantee.