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
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 RVU | 8.05 |
| Practice expense RVU | 7.66 |
| Malpractice RVU | 1.62 |
| Total RVU | 17.33 |
| Medicare national rate | $578.84 |
| Global period | 90 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
| Setting | Medicare 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?
02Which ICD-10 codes pair most commonly with 24102?
03Is 24102 performed arthroscopically or open?
04What modifier applies if a complication requires the surgeon to return to the OR during the 90-day global?
05Does the site of service affect payment for 24102?
06When is modifier 22 justified for 24102?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02mdclarity.comhttps://www.mdclarity.com/cpt-code/24102
- 03abos.orghttps://www.abos.org/wp-content/uploads/2019/12/sports-cpt-updated.pdf
- 04aapc.comhttps://www.aapc.com/codes/coding-newsletters/my-orthopedic-coding-alert/aaos-releases-bundling-guidelines-for-new-cpt-surgical-codes-article
- 05healthcareinspiredllc.comhttps://healthcareinspiredllc.com/rheumatoid-arthritis-factor-or-not/
- 06eatonhand.comhttps://www.eatonhand.com/coding/n24102.htm
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