Surgical removal of the olecranon bursa at the posterior elbow, performed as a complete excision rather than drainage or aspiration.

Verified May 8, 2026 · 6 sources ↓

Medicare: $358.06
Total RVUs: 10.72
Global, days: 90
Region: Elbow

Drawn from CMSAAPCThrivemedicalbillingMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Operative note must explicitly state complete excision of the olecranon bursa, not just drainage or decompression
Describe the extra-articular location of the bursa and confirm no intra-articular joint entry was made
Document the indication: chronic bursitis, recurrent bursitis, or septic bursitis with failed conservative treatment
Note specimen disposition if tissue was sent to pathology, particularly for septic or atypical presentations
If billing with a companion procedure (e.g., 24110 or 64718), document each procedure as a distinct, separately performed service with its own operative steps
For modifier 22, document specific complexity factors: extensive infection, dense adhesions, revision setting, or prolonged operative time with explanation

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

24105 covers complete surgical excision of the olecranon bursa — the extra-articular sac overlying the tip of the elbow. Use it when the operative note documents full bursectomy, typically for chronic, recurrent, or septic bursitis that has failed conservative management. If the note describes only incision and drainage, that's 23931, not 24105. The distinction matters: the op note must support complete excision, not merely decompression.

The olecranon bursa is extra-articular. Arthrotomy codes 24100 and 24101 describe intra-articular elbow work and are not interchangeable with 24105 for bursal surgery. Similarly, aspiration or injection of the olecranon bursa codes as an intermediate bursa procedure (20605 with or 20606 without ultrasound) — not with major-joint codes 20610/20611. Mixing these up is one of the most common audit flags for elbow billing.

Under NCCI, 24105 bundles with 24110 (tumor excision, humerus) but the edit allows a modifier to unbundle when the procedures are genuinely distinct and separately documented. 24105 also bundles with ulnar nerve transposition at the elbow (64718) per NCCI — if the ulnar nerve release was at the wrist (64719), the bundle does not apply. There is no dedicated arthroscopic code for extra-articular olecranon bursectomy; most payers direct arthroscopic extra-articular excision to 24999 with supporting documentation and prior authorization.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.69
Practice expense RVU	6.28
Malpractice RVU	0.75
Total RVU	10.72
Medicare national rate	$358.06
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	$358.06
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 24105 get rejected.

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

Op note describes I&D or aspiration only — procedure does not meet excision criteria for 24105
NCCI bundle denial when 24105 is billed same-day with 24110 or 64718 without a supporting modifier and distinct documentation
Incorrect bursa size classification: billing major-joint injection codes (20610) for olecranon bursa work instead of intermediate codes (20605/20606)
Arthroscopic extra-articular bursectomy billed as 24105 when payer requires 24999 with prior authorization for arthroscopic approach
Post-op follow-up visits billed without modifier 24 during the 90-day global period when the visit is routine surgical aftercare

Frequently asked questions

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

01What's the difference between 24105 and 23931 for elbow bursa work?

24105 is complete surgical excision of the olecranon bursa. 23931 is incision and drainage of an upper arm or elbow bursa. If the op note doesn't document complete removal of the bursal tissue, bill 23931 — not 24105. The global periods differ too: 24105 carries a 90-day global; 23931 is a 10-day global.

02Can I bill 24105 and 24110 together on the same date?

NCCI bundles 24105 into 24110, but the edit allows a modifier to unbundle when both procedures are genuinely distinct and separately documented. Use modifier 59 (or XS) and ensure the operative note describes each procedure with its own surgical steps. Payer policies vary — some commercial payers may still deny regardless of modifier.

03Which injection code do I use for olecranon bursa aspiration in the office?

The olecranon bursa is classified as intermediate, so use 20605 (without ultrasound guidance) or 20606 (with ultrasound guidance). Do not use 20610 or 20611 — those are for major joints. Upcoding to a major-joint code for olecranon bursa work is an audit flag.

04Is there an arthroscopic CPT code for olecranon bursectomy?

No dedicated arthroscopic code exists for extra-articular olecranon bursectomy. Most payers direct this to 24999 (unlisted procedure, humerus or elbow), which requires supporting documentation and typically prior authorization. Confirm the payer's policy before scheduling an arthroscopic approach.

05How do I handle billing during the 90-day global period after 24105?

The 90-day global covers routine post-op visits, dressing changes, and stitch removal. If you see the patient during the global period for an unrelated problem, append modifier 24 to the E/M. If you perform a new unrelated procedure during the global period, use modifier 79. An unplanned return to the OR for a related complication gets modifier 78.

06When does modifier 22 apply to 24105?

Modifier 22 is appropriate when the excision required significantly greater work than typical — for example, extensive septic bursitis with deep tissue involvement, dense adhesions in a revision case, or prolonged operative time. The operative note must explain what made the case unusually complex. Without documentation, expect payer requests for medical records before reimbursement.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the approach (open vs. attempted arthroscopic), confirmation of complete bursa excision versus I&D only, extra-articular versus intra-articular location, the clinical indication (chronic, recurrent, or septic), and any concurrent procedures performed at the same operative session. This prevents the most common denial for 24105 — an op note that reads as drainage rather than excision — and flags same-day procedure combinations that trigger NCCI bundle edits before the claim goes out.

See how Mira captures CPT 24105 documentation