Arthroscopy · Elbow

24102

Open elbow surgery involving joint incision and removal of inflamed synovial tissue (synovectomy) to reduce pain and restore function.

Verified May 8, 2026 · 6 sources ↓

Medicare
$578.84
Total RVUs
17.33
Global, days
90
Region
Elbow
Drawn from CMSMdclarityAbosAAPCHealthcareinspiredllc

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 6 cited references ↓

  • Diagnosis driving the synovectomy — specify ICD-10 (e.g., M06.821/M06.822 for RA, right or left elbow) with seropositivity or seronegativity documented
  • Operative note must name the surgical approach used to open the joint, not just 'standard approach'
  • Extent of synovectomy documented — compartments addressed, amount of synovium excised, any additional pathology encountered
  • Laterality clearly stated in both the operative note header and the body of the report
  • Pre-op imaging or clinical history supporting medical necessity of open synovectomy over non-operative or arthroscopic alternatives
  • If modifier 22 is used, a separate narrative explaining what made the procedure significantly more complex than typical

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 24102 covers an open arthrotomy of the elbow with synovectomy — the surgeon opens the joint and excises the synovial membrane, which has become inflamed and hypertrophied, typically from rheumatoid arthritis or other inflammatory arthropathy. This is a distinct procedure from a simple joint exploration (24101) and from capsular release (24006); billing any of those alongside 24102 will trigger bundling edits. AAOS Global Service Data confirms that arthrotomy codes 24000, 24100, 24101, and 24102 are included components of elbow ligament repair/reconstruction codes (24343–24346) — don't unbundle them.

The 90-day global period means all routine post-op care through day 90 is wrapped into the payment. Any unrelated procedure in that window needs modifier 79; a related return to the OR for a complication uses modifier 78. Because RA commonly affects multiple joints, laterality modifiers (LT/RT) are critical — payers will reject or pend claims without them when the bilateral nature of the disease creates ambiguity. If both elbows are done in the same session, bill with modifier 50 and document each side's operative findings separately.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU8.05
Practice expense RVU7.66
Malpractice RVU1.62
Total RVU17.33
Medicare national rate$578.84
Global period90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$578.84
HOPD (APC 5113)
Hospital outpatient department
$3,342.87
ASC (PI A2)
Ambulatory surgical center (freestanding)
$1,644.87

Common denial reasons

The recurring reasons claims for CPT 24102 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

  • Missing laterality modifier — payer cannot determine which elbow was treated and pends or denies the claim
  • Bundling denial when 24006 (capsular release) or 24101 (joint exploration) is billed same-day — these are included components
  • Medical necessity denial when documentation doesn't establish failure of conservative management prior to open synovectomy
  • Global period conflict — post-op services billed without modifier 24 or 79 when another surgeon's global is active
  • ICD-10 mismatch — RA code laterality does not match the LT/RT modifier on the CPT line

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Can 24102 and 24006 be billed together on the same elbow?
No. AAOS bundling guidance treats arthrotomy codes including 24102 as components of elbow procedures that include capsular work. Billing both will draw a bundling denial. If a true capsular release was performed beyond the synovectomy, document it thoroughly and be prepared to appeal with operative note detail — but expect pushback.
02Which ICD-10 codes pair most commonly with 24102?
Rheumatoid arthritis codes are the primary drivers: M06.821 (RA, right elbow) and M06.822 (RA, left elbow). Seronegative RA maps to M06.021/M06.022. Other inflammatory arthropathies such as psoriatic arthritis (L40.5x) or chronic post-traumatic synovitis (M67.321/M67.322) also support medical necessity — match laterality exactly to your CPT modifier.
03Is 24102 performed arthroscopically or open?
24102 is an open arthrotomy procedure. Arthroscopic elbow synovectomy is reported with 29836 (arthroscopic, with extensive synovectomy) or 29834/29835 depending on scope of work. Don't use 24102 for an arthroscopic approach — that's an incorrect code assignment that will fail audit.
04What modifier applies if a complication requires the surgeon to return to the OR during the 90-day global?
Modifier 78 covers an unplanned return to the OR for a complication related to the original procedure. Use modifier 79 only if the return surgery is for a completely unrelated condition. Inverting these is a compliance error — 78 = related, 79 = unrelated.
05Does the site of service affect payment for 24102?
Yes, significantly. The HOPD and ASC payment rates differ — see the Site of Service comparison on this page. Physician work RVUs remain constant regardless of setting, but the facility component does not. When counseling patients on out-of-pocket costs or choosing a facility, the difference between ASC and HOPD rates is material.
06When is modifier 22 justified for 24102?
Modifier 22 is appropriate when the procedure required substantially greater work than typical — for example, severe periarticular fibrosis, prior failed surgery creating dense adhesions, or extensive multi-compartment synovial involvement requiring significantly longer operative time. The operative note must quantify the added complexity; vague language like 'difficult case' will not support the modifier on audit or appeal.

Mira AI Scribe

Mira's AI scribe captures the surgical approach to joint entry, compartments where synovectomy was performed, degree of synovial hypertrophy encountered, and any concurrent pathology addressed — along with explicit laterality. This prevents the most common audit flag for 24102: an operative note that confirms a synovectomy was done but doesn't document the extent or side well enough to defend medical necessity or rebuff a bundling challenge.

See how Mira captures CPT 24102 documentation

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