CPT® Code 29828

The procedure described by CPT® Code 29828 refers to an arthroscopic surgical technique performed on the shoulder, specifically focusing on biceps tenodesis. This procedure involves the creation of a posterior portal to gain access to the glenohumeral joint, which is the ball-and-socket joint of the shoulder. During the surgery, the joint is visualized, allowing the surgeon to examine the biceps tendon for any signs of fraying, inflammation, or tears, as well as to assess the condition of the rotator cuff for potential injuries. The use of a probe through a second anterior portal enables the surgeon to exert traction on the tendon, bringing the extra-articular portion of the tendon into view for debridement, which is the removal of damaged tissue. Additionally, a spinal needle is introduced percutaneously, which is a minimally invasive technique, and is passed through the biceps tendon to anchor it to the bone. An alternative method involves capturing the tendon by threading a stitch through the spinal needle and pulling it through the anterior portal. Once the tendon is cut and delivered through the anterior portal, the arthroscope is repositioned to visualize the subacromial space, which is the area beneath the acromion of the shoulder blade. To facilitate the procedure, a lateral portal is created to allow for the insertion of additional instruments necessary for dividing the capsular tissue of the rotator interval, thereby exposing the biceps tendon and the bicipital groove. If the bicipital groove is found to be flattened, it may be deepened using a round burr to ensure proper placement of the tendon. The procedure concludes with the insertion of two anchors into the humerus at the bicipital groove, where sutures are placed through the biceps tendon and secured to these anchors. Alternatively, a bone tunnel may be created to secure the end of the biceps tendon, which is then placed into the tunnel and fixed using a screw. This comprehensive approach aims to alleviate pain and restore function in patients suffering from biceps tendon pathology.