Surgical removal or curettage of a bone cyst or benign tumor located at the head or neck of the radius or the olecranon process of the elbow.

Verified May 8, 2026 · 5 sources ↓

Medicare: $507.36
Work RVU: 6.65
Global, days: 90
Region: Elbow

Drawn from CMSFindacodeEmedny

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Specify the exact anatomic site: head of radius, neck of radius, or olecranon process — not just 'elbow tumor'
Identify lesion type (bone cyst vs. benign tumor) with pathology or intraoperative findings supporting the diagnosis
Document whether defect was left open, packed with local/autograft, or filled with bone substitute — allograft use triggers 24116 instead
Record lesion size and depth, as these support medical necessity and modifier 22 if complexity was significantly elevated
Include pre-operative imaging (X-ray, CT, or MRI) referenced in the operative note to establish diagnosis and surgical planning
Document the surgical approach and confirm the procedure was open, not arthroscopic

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 52 Reduced services 57 Decision for surgery 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 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 5 cited references ↓

CPT 24120 covers open excision or curettage of a bone cyst or benign tumor arising at the head or neck of the radius or the olecranon process. The surgeon opens the elbow, removes the lesion, and may pack the resulting defect with local bone graft or bone substitute — if allograft is used instead, that upgrades to 24116. The distinction between these codes is critical: payers will deny 24120 when operative documentation describes allograft filling.

The 90-day global period means all routine follow-up, wound checks, and cast or splint management through day 90 are bundled into the surgical payment. Unrelated E/M services in that window require modifier 24; a separately identifiable pre-operative E/M on the same day requires modifier 57 if the decision for surgery was made that day.

Site of service matters here. The HOPD and ASC payment differentials are significant — see the Site of Service comparison table on this page. Surgeons performing this in office must verify that facility-level resources and anesthesia support are appropriate, as payers increasingly scrutinize elbow bone tumor excisions billed in non-facility settings.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (6.65) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (15.19) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.65
Practice expense RVU	7.2
Malpractice RVU	1.34
Total RVU	15.19
Medicare national rate	$507.36
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	$507.36
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 24120 get rejected.

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

Allograft documented in the operative note but 24120 billed instead of 24116, causing code-to-documentation mismatch
Insufficient pre-operative imaging or pathology to support medical necessity for excision of a benign lesion
Routine post-op services billed separately within the 90-day global period without modifier 24 or 79
Anatomic site not specified — payers require documentation distinguishing radial head/neck from olecranon process
Same-day E/M billed without modifier 25 when a separate, significant evaluation was performed before the surgical decision

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What is the difference between CPT 24120 and 24116?

24120 covers excision or curettage with no graft or local/autograft only. 24116 is used when an allograft is placed to fill the defect. If your operative note documents allograft, bill 24116 — billing 24120 in that scenario is a code-to-documentation mismatch.

02Does CPT 24120 carry a global period, and what does that include?

Yes — 24120 has a 90-day global period. Routine post-op visits, wound checks, suture removal, and splint or cast management within that window are bundled. Bill unrelated services with modifier 24 (E/M) or modifier 79 (unrelated procedure).

03Can I bill a same-day E/M with CPT 24120?

Yes, if the E/M was separately identifiable and beyond the pre-op assessment. Use modifier 25 if the visit occurred the same day as surgery and modifier 57 if the decision for surgery was made at that encounter.

04When is modifier 22 appropriate with 24120?

Modifier 22 applies when the procedure required substantially greater work than typical — for example, a large or densely adherent lesion requiring extended dissection, or significant anatomic distortion. Document time, difficulty, and specific intraoperative findings. Without that documentation, payers routinely deny the increased complexity claim.

05Is CPT 24120 billable bilaterally?

Bilateral elbow bone cyst excision is rare but codeable. Use modifier 50 for bilateral same-session procedures, or LT/RT if your payer requires laterality modifiers on separate claim lines. Confirm with your MAC, as bilateral elbow procedures trigger scrutiny.

06What ICD-10 diagnoses support medical necessity for 24120?

Common supporting diagnoses include M85.321–M85.329 (solitary bone cyst, forearm), D16.0 (benign neoplasm of scapula and long bones of upper limb), and M85.421–M85.429 (solitary bone cyst of the humerus). Confirm specificity to the radial head/neck or olecranon and use the most specific laterality code available.

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 exact lesion location (radial head, radial neck, or olecranon process), lesion type, graft material used, and whether the defect was packed or left open — the documentation chain that separates a clean 24120 claim from a 24116 upgrade or a medical-necessity denial. If the surgeon dictates allograft use, the scribe flags the code mismatch before the claim goes out.

See how Mira captures CPT 24120 documentation