CPT 29805 Surgery - Musculoskeletal

How Much Does Shoulder Arthrs Diagnostic +- Synovial Biopsy Cost?

Also known as: Sho arthrs dx +- synovial bx (CPT 29805)

Diagnostic shoulder arthroscopy using a tiny camera to look inside the shoulder joint.

The total estimated cost of Shoulder Arthrs Diagnostic +- Synovial Biopsy (CPT 29805) is $1,509 to $2,828, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $449.

Total Estimated Cost of Care

$1,509 — $2,828

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$449
Hospital Facility Fee
$1,347
Anesthesia (est.)
$90
Important: The physician fee of $449 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$449
Physician component only — CMS PFS 2026

Patient Guide: Shoulder Arthrs Diagnostic +- Synovial Biopsy

What you need to know before your appointment

What to Expect

Under anesthesia, the surgeon inserts a small camera through tiny incisions to examine the inside of your shoulder, including the rotator cuff, labrum, and cartilage.

How Long Does It Take?

30-45 minutes

Common Reasons Doctors Order This

Shoulder pain of unclear cause, evaluation of rotator cuff, assessment of labral damage, unexplained shoulder symptoms

How to Prepare

Fast after midnight. Arrange a ride home. Wear a button-up shirt for easy dressing afterward. Have a sling available.

Procedures Commonly Done Together

These procedures are frequently performed alongside Sho arthrs dx +- synovial bx

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How to Reduce Your Cost for Sho arthrs dx +- synovial bx

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

5.88
Work RVU
6.35
Practice Expense RVU
1.21
Malpractice RVU
13.44
Total RVU

Payment = Total RVU (13.44) x CF ($33.40) = $449

Frequently Asked Questions

How much does Sho arthrs dx +- synovial bx cost?

The Medicare facility rate for Sho arthrs dx +- synovial bx is $449. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Sho arthrs dx +- synovial bx cost without insurance?

Without insurance, the cost of Sho arthrs dx +- synovial bx can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Sho arthrs dx +- synovial bx?

Most commercial health insurance plans and Medicare cover Sho arthrs dx +- synovial bx when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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