Surgical removal or curettage of a bone cyst or benign tumor located in the humerus, without bone grafting.

Verified May 8, 2026 · 6 sources ↓

Medicare: $566.15
Total RVUs: 16.95
Global, days: 90
Region: Elbow

Drawn from CMSAAPCEmednyNIHHopkinsmedicine

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 name the specific lesion type (bone cyst, enchondroma, osteochondroma, etc.) and confirm it is benign or presumed benign preoperatively.
Document the exact location on the humerus (proximal, shaft, distal) and size of the lesion.
Confirm no bone graft was used — if graft was placed intraoperatively, 24110 is incorrect; use 24115 or 24116.
Pathology report should be ordered and linked to the operative note to support the benign tumor or cyst diagnosis.
If billing with 24105 same-day, document that each procedure was performed at a separate, distinct anatomic site with its own incision.
Laterality must be documented — left or right humerus — to support LT or RT modifier on the claim.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 51 Multiple procedures 57 Decision for surgery 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 24110 covers open excision or curettage of a bone cyst or benign tumor of the humerus — the upper arm bone — without the use of a bone graft. The procedure involves exposing the lesion, removing or scraping out the pathological tissue, and closing the wound. When grafting is required to fill the resulting defect, step up to 24115 (autograft) or 24116 (allograft) instead.

This code carries a 90-day global period. All routine post-op visits, wound checks, and related management through day 90 are bundled. Bill unrelated E/M services in that window with modifier 24; a separately identifiable pre-decision E/M on the day of surgery requires modifier 57 if the decision to operate was made that day.

Under NCCI policy, 24105 (olecranon bursa excision) bundles into 24110. A modifier can unbundle them if the procedures are distinct and separately documented, but verify your payer's policy — commercial carriers vary on whether they honor that unbundle.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	7.39
Practice expense RVU	7.99
Malpractice RVU	1.57
Total RVU	16.95
Medicare national rate	$566.15
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	$566.15
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 24110 get rejected.

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

Upcoding to 24115/24116 when no graft was placed, or downcoding to 24110 when a graft was documented — code selection must match the operative note exactly.
Missing or inconclusive pathology documentation; payers flag benign tumor excisions without pathology confirmation as lacking medical necessity support.
24105 billed same-day without a modifier and without documentation of a distinct anatomic site, triggering an NCCI bundle denial.
Laterality modifier (LT or RT) absent, causing claim rejection at clearinghouse or payer edit level.
Post-op E/M visits billed without modifier 24 during the 90-day global period, resulting in automatic denial as bundled services.

Frequently asked questions

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

01What's the difference between 24110, 24115, and 24116?

24110 is excision or curettage of a humeral bone cyst or benign tumor with no grafting. 24115 adds an autograft — graft harvested from the same patient, with harvest included in the code. 24116 uses an allograft. If the defect was filled with anything, 24110 is wrong.

02Can I bill 24105 and 24110 on the same operative session?

Under NCCI, 24105 bundles into 24110. You can append a modifier to unbundle if the olecranon bursa excision and the humeral tumor excision were performed through separate incisions at distinct anatomic sites, and the operative note documents both separately. Confirm your payer accepts the unbundle before appealing a denial.

03Does 24110 require a pathology report?

CMS does not mandate a pathology report as a condition of payment, but absence of one is a medical necessity audit flag. Payers and RAC auditors look for pathology to confirm the lesion was benign. Send the specimen and link the report to the chart.

04How do I bill a same-day E/M if the surgeon decided to operate at that visit?

Use modifier 57 on the E/M when the decision for surgery was made on the same day as the procedure. Modifier 25 is for minor procedures; 24110 carries a 90-day global, making it a major procedure — modifier 57 is correct here.

05What ICD-10 diagnoses support 24110?

Common supporting diagnoses include M85.32–M85.329 (solitary bone cyst, humerus), D16.02–D16.12 (benign neoplasm of humerus), and M85.52–M85.529 (aneurysmal bone cyst, humerus). Match the specific site and laterality to the code.

06Is 24110 performed in an ASC or hospital outpatient department?

Both. The site of service affects facility payment rates — see the Site of Service comparison table on this page. The physician's professional fee is also affected by site of service under Medicare's site-of-service differential rules.

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 lesion type, anatomic location on the humerus, laterality, lesion size, and whether any bone graft material was placed — the four details that determine whether 24110, 24115, or 24116 is correct. That prevents the most common post-audit downcode: a surgeon dictates 'defect filled' without specifying graft use, and the coder defaults to 24110 when 24115 was actually performed.

See how Mira captures CPT 24110 documentation