Knee Arthroscopy with Meniscectomy / Meniscus Repair

CPT 29881
Approach Arthroscopic
Add-on / Variant CPTs
  • 29882 — Arthroscopy, knee, with meniscus repair (medial OR lateral)
  • 29883 — Arthroscopy, knee, with meniscus repair (medial AND lateral)
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 / medial meniscus repair / partial lateral meniscectomy / lateral meniscus repair]

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 [Outerbridge Grade X 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. The tear was reduced and the sutures held [without tearing through]. [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 crutches 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 ***.

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.] 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. Fat droplets confirmed adequate 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.

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 decision to repair vs. resect. In young patients, err toward repair even in borderline zones.
  • Document ACL status. A concomitant ACL tear changes the surgical plan significantly (combined reconstruction + repair). 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. All-inside devices can fail if the tear is not reduced before tensioning. Document 'probe confirmed reduction with no gapping' to confirm the repair held.
Billing Tips
  • Bill 29880 for knee arthroscopy with meniscectomy, medial AND lateral (7.21 wRVU, 90-day global). Bill 29881 for meniscectomy of medial OR lateral meniscus only (6.85 wRVU). Document which meniscus(i) were resected.
  • Meniscal repair uses 29882 (medial or lateral, 11.91 wRVU) or 29883 (both, 13.41 wRVU), which carry higher wRVU than meniscectomy. Repair vs. resection is a key billing distinction. Document the decision-making: tear pattern, tissue quality, repair feasibility.
  • Chondroplasty (29877) performed at the same setting may be separately billable. Confirm with your billing team, as some payers bundle it with meniscectomy. Document the chondral lesion location, grade, and treatment.
  • 90-day global period: physical therapy, brace management, and routine follow-up are bundled. Repeat arthroscopy within the global period requires modifier -78 (unplanned return) or -58 (staged procedure).
  • Do not bill a diagnostic arthroscopy code (29870) in addition to surgical arthroscopy. The diagnostic component is bundled when surgery is performed. Bill only the surgical code.