CPT 29870 Surgery - Musculoskeletal

How Much Does Arthrs Knee Diagnostic with Wo Syn Biopsy Cost?

Also known as: Arthrs knee dx w/wo syn bx (CPT 29870)

Diagnostic knee arthroscopy using a small camera to look inside your knee joint.

The total estimated cost of Arthrs Knee Diagnostic with Wo Syn Biopsy (CPT 29870) is $1,343 to $2,519, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $400.

Total Estimated Cost of Care

$1,343 — $2,519

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

Surgeon/Physician Fee
$400
Hospital Facility Fee
$1,199
Anesthesia (est.)
$80
Important: The physician fee of $400 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)
$400
Physician component only — CMS PFS 2026
Medicare Physician Fee (Office/Clinic)
$603
Non-facility setting

Patient Guide: Arthrs Knee Diagnostic with Wo Syn 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 knee. If problems are found, they may be treated at the same time.

How Long Does It Take?

30-45 minutes

Common Reasons Doctors Order This

Unexplained knee pain, knee locking or catching, evaluation of knee swelling, pre-surgical assessment

How to Prepare

Fast after midnight. Arrange a ride home. Wear loose shorts or pants. Have ice packs ready at home.

Procedures Commonly Done Together

These procedures are frequently performed alongside Arthrs knee dx w/wo syn bx

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How to Reduce Your Cost for Arthrs knee dx w/wo syn 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

    For this procedure, the office rate ($603) differs from the facility rate ($400). Ask if it can be done in an office setting.

  • 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.

5.06
Work RVU
5.88
Practice Expense RVU
1.03
Malpractice RVU
18.05
Total RVU

Payment = Total RVU (18.05) x CF ($33.40) = $603

Frequently Asked Questions

How much does Arthrs knee dx w/wo syn bx cost?

The Medicare facility rate for Arthrs knee dx w/wo syn bx is $400. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Arthrs knee dx w/wo syn bx cost without insurance?

Without insurance, the cost of Arthrs knee dx w/wo syn 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 Arthrs knee dx w/wo syn bx?

Most commercial health insurance plans and Medicare cover Arthrs knee dx w/wo syn 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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