Knee Arthroscopy with Meniscectomy / Meniscus Repair

CPT 29881 · 6.85 wRVU · 90-day global
CPT29881
wRVU6.85
Global90-day
ApproachArthroscopic
ComplexityModerate
Preoperative Diagnosis:

Right [left] [medial / lateral] meniscus tear, [bucket-handle / horizontal / radial / complex degenerative]

Postoperative Diagnosis:

Same

Procedure Performed:

Right [left] knee arthroscopy with [partial medial meniscectomy (29881) / medial meniscus repair (29882) / partial lateral meniscectomy (29881) / lateral meniscus repair (29882) / bilateral meniscectomy (29880) / bilateral meniscus repair (29883)]

Attending Surgeon:

[Attending name], MD/DO

First Assistant:

[Resident/PA name]

Anesthesia:

Spinal [/ general endotracheal] [/ laryngeal mask airway]

Indications:

The patient is a [age]-year-old [male/female] with right [left] [medial / lateral] meniscus tear confirmed on MRI, presenting with [medial / lateral] joint line pain, [locking / catching / giving way], not responsive to conservative management. The risks, benefits, and alternatives were discussed and informed consent was obtained.

Findings:

Arthroscopic examination confirmed a [bucket-handle / posterior horn / radial / horizontal cleavage] tear of the [medial / lateral] meniscus. The tear extended from the [anterior / middle / posterior] horn and measured approximately [X] cm. The tear was [in the red-red zone / red-white zone / white-white zone (avascular, not repairable)]. [The ACL was intact. The PCL was intact.] Articular cartilage was [intact / Outerbridge Grade [I–IV] at the medial/lateral femoral condyle / tibial plateau]. [The contralateral compartment was normal.]

Description of Procedure:

The patient was positioned supine with a thigh tourniquet and a leg holder. Standard anterolateral and anteromedial portals were established. A systematic diagnostic arthroscopy was performed, examining all compartments including the patellofemoral joint, medial and lateral compartments, and the intercondylar notch.

[PARTIAL MENISCECTOMY:]
The [medial / lateral] meniscus tear was visualized. A [basket forceps / motorized shaver] was used to remove the unstable torn fragment, preserving as much healthy meniscal tissue as possible. Meniscal probing confirmed a stable residual rim. The articular surface was inspected and any loose chondral fragments removed.

[MENISCUS REPAIR (ALL-INSIDE):]
The tear was in the vascular red-red [/ red-white] zone and was amenable to repair. The tear edges were freshened with a [rasp / motorized shaver] to stimulate healing. An [all-inside repair device (e.g., FasT-Fix, CrossFix)] was used to place [X] sutures across the tear from posterior to anterior. Each stitch was tensioned and locked. The repair was tested with a probe confirming reduction without gapping. [Outside-in supplemental sutures were placed for the anterior horn.]

Final arthroscopic inspection confirmed adequate resection [/ secure repair] and no loose bodies. The tourniquet was deflated. Portals were closed with [3-0 Monocryl]. A sterile dressing was applied.

Complications:

None

Specimens:

[Meniscal fragment sent to pathology if removed]

Estimated Blood Loss:

Minimal

Drains:

None

Disposition:

The patient was taken to the PACU in stable condition. [Partial meniscectomy: weight-bearing as tolerated with crutches; discontinue when comfortable.] [Meniscus repair: non-weight-bearing for [4–6 weeks]; protected ROM on crutches.] Physical therapy was prescribed.

Epic SmartPhrase Version 
PREOPERATIVE DIAGNOSIS: Right/Left *** meniscus tear
POSTOPERATIVE DIAGNOSIS: Same
PROCEDURE PERFORMED: Right/Left knee arthroscopy with *** meniscectomy/repair
ATTENDING: ***, MD/DO
ASSISTANT: ***
ANESTHESIA: Spinal/LMA

INDICATIONS: .PTAGE-year-old .PTSEX with *** meniscus tear, failed conservative management. Consent obtained.

FINDINGS: *** tear, *** horn, *** cm. Zone: ***. ACL/PCL intact. Articular cartilage: Outerbridge *** at ***.

PROCEDURE:
Supine, tourniquet, leg holder. AL/AM portals. Systematic diagnostic scope; findings above. [Partial meniscectomy: unstable fragment removed, basket/shaver, stable rim confirmed.] [Repair: edges freshened, *** all-inside devices placed posterior to anterior, tensioned and locked, probe confirmed reduction without gapping.] Final scope: adequate resection/repair, no loose bodies. Tourniquet deflated. Portals closed. Dressing.

EBL: Minimal
COMPLICATIONS: None
DISPOSITION: [WBAT/NWB *** weeks]. PT prescribed.

Signed: .ME, .MYDEGREE
.TODAY
Variants

Concomitant Chondroplasty / Microfracture

A [Grade III–IV] full-thickness chondral defect was identified at the [medial femoral condyle / trochlea / patella], measuring [X × X] mm. [Chondroplasty: the unstable cartilage margins were debrided to stable vertical walls with a curette and shaver. The lesion surface was smoothed.] [Microfracture: the calcified cartilage layer was debrided to expose subchondral bone. An awl was used to create microfracture holes 3–4 mm deep at 3–4 mm intervals until fat droplets confirmed adequate marrow penetration. Post-operatively, the patient will remain non-weight-bearing for 6–8 weeks.] Microfracture is appropriate for lesions <2 cm²; larger lesions may benefit from osteochondral transplantation or cartilage restoration procedures. Billing note: chondroplasty is bundled into 29880/29881 descriptors (NCCI modifier indicator 0) and cannot be separately billed with meniscectomy codes under any circumstances. When performed alongside meniscus repair codes (29882/29883) in a different compartment, G0289 (Medicare) or 29877 (commercial payers) may be separately reportable — confirm payer policy.

Charting Tips
  • Document meniscal zone. Red-red zone tears (peripheral, vascular) are repairable; white-white zone tears (central, avascular) are not. Document the zone and the rationale for repair vs. resection. In young patients, err toward repair even in borderline zones.
  • Document ACL status. A concomitant ACL tear significantly changes the surgical plan — an unstable knee with ACL deficiency and a repaired meniscus has poor outcomes without ACL reconstruction. Document that the ACL was evaluated and its status.
  • For meniscus repair, document repair technique, number of implants placed, and post-repair probe test. Document 'probe confirmed reduction without gapping' to confirm the repair held and support the repair code over meniscectomy.
  • ICD-10 specificity: traumatic/acute tears use S83.2xx with laterality and encounter type. Chronic/degenerative tears use M23.2xx. These families are mutually exclusive — document mechanism and chronicity explicitly. Mixing the families is a payer-flagged coding error.
Billing Tips
  • 29880 (meniscectomy, medial AND lateral; 7.21 wRVU, 90-day global) and 29881 (meniscectomy, medial OR lateral; 6.85 wRVU, 90-day global) are standalone primary codes for meniscectomy. 29882 (meniscus repair, medial or lateral; 9.36 wRVU, 90-day global) and 29883 (meniscus repair, both; 11.48 wRVU, 90-day global) are standalone primary codes for repair. All four carry 90-day global periods and are mutually exclusive alternatives — not add-on codes. A surgeon bills repair OR meniscectomy for each compartment, not both. Repair codes carry higher wRVU than meniscectomy; document the repair decision explicitly.
  • Chondroplasty (29877) is BUNDLED into 29880 and 29881 and cannot be separately billed with meniscectomy codes regardless of compartment. Since 2012, the AMA revised 29880 and 29881 descriptors to explicitly include 'debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed.' The NCCI edit has a '0' modifier indicator — this edit cannot be overridden for meniscectomy codes. With meniscus repair codes (29882/29883), chondroplasty performed in a different compartment may be separately reportable using G0289 (Medicare) or 29877 (most commercial payers); confirm payer policy before billing.
  • Repeat knee arthroscopy within the 90-day global period: modifier -78 (unplanned return to the OR for a related complication) is correct in most scenarios. Modifier -58 (staged procedure) is only appropriate when the second arthroscopy was planned and documented as staged at the time of the index surgery. Do not use -58 routinely for symptom recurrence or re-tear.
  • Do not bill diagnostic arthroscopy (29870) in addition to surgical arthroscopy. CPT 29870 is designated 'separate procedure' and is automatically bundled whenever any surgical knee arthroscopy code is reported for the same knee on the same date.
  • ICD-10: Traumatic/acute meniscus tear = S83.2xx (laterality required; 7th character A=initial encounter for closed injury, D=subsequent, S=sequela). Degenerative/old tear = M23.2xx (derangement of meniscus due to old tear or injury). These are mutually exclusive — do not use S83.2- for a chronic degenerative tear or M23.2- for an acute traumatic tear. Document mechanism and chronicity to support code selection.

General coding reference. Verify with your institution’s billing department before submitting claims.

ⓘ General Billing Tips →