Soft tissue repair · Elbow

24140

Partial excision of the humerus via craterization, saucerization, or diaphysectomy — typically performed for osteomyelitis, bone abscess, or similar destructive bone pathology of the humeral shaft or distal humerus.

Verified May 8, 2026 · 5 sources ↓

Medicare
$655.99
Total RVUs
19.64
Global, days
90
Region
Elbow
Drawn from CMSEmednyAAPCEatonhand

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 surgical technique by name: craterization, saucerization, or diaphysectomy — not just 'partial excision'
  • Identify the exact anatomic location on the humerus (shaft, distal humerus) and laterality (left or right)
  • Document the pathological indication: osteomyelitis, bone abscess, or other destructive bone condition with supporting cultures or imaging
  • Record the extent of bone removed, including dimensions or description of the defect created
  • Note whether bone grafting, wound irrigation, or antibiotic bead placement was performed as a concurrent service
  • Include preoperative imaging (X-ray, MRI, or CT) confirming the lesion location and extent in the medical record

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 LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 24140 covers open surgical removal of a portion of the humerus using techniques such as craterization (scooping out a crater of infected or diseased bone), saucerization (creating a shallow dish-shaped defect to allow drainage and healing), or diaphysectomy (resecting a segment of the humeral diaphysis). The classic indication is osteomyelitis or a bone abscess that has not resolved with conservative management, but the code also applies to other pathological processes requiring partial humeral resection short of radical tumor resection.

The 90-day global period means all routine post-op management from the day before surgery through day 90 is included in the base payment. Any visit or service unrelated to the bone excision during that window requires modifier 24 (E/M) or 79 (unrelated procedure). If a concurrent procedure — such as bone grafting or hardware removal — is performed at the same site, scrutinize NCCI edits before appending modifier 59 or 51; bundling rules govern what unbundles legitimately.

Site-of-service selection has significant reimbursement implications: HOPD and ASC facility payments differ substantially (see the Site of Service comparison table). Document the specific technique used — craterization, saucerization, or diaphysectomy — and the location on the humerus (shaft, distal). Operative notes that omit the technique name and fail to quantify the extent of bone removed are the primary audit target for this code.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU9.31
Practice expense RVU8.42
Malpractice RVU1.91
Total RVU19.64
Medicare national rate$655.99
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
$655.99
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 24140 get rejected.

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

  • Operative note lacks the specific technique name (craterization/saucerization/diaphysectomy), triggering a medical necessity or specificity denial
  • Claim submitted during a 90-day global period of a prior humeral procedure without modifier 79 for an unrelated service or modifier 78 for a related return to the OR
  • Laterality not documented or not reflected on the claim, causing payer rejection or downcoding
  • Concurrent bone grafting billed separately without establishing that it is a distinct service, resulting in bundling denial under NCCI edits
  • Diagnosis code does not support partial excision (e.g., a benign cyst without documented failure of conservative treatment, when payer policy requires it)

Frequently asked questions

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

01Is 24140 the right code for osteomyelitis of the humeral shaft requiring open debridement?
Yes, when the procedure involves craterization, saucerization, or diaphysectomy of the humeral shaft or distal humerus for osteomyelitis or bone abscess, 24140 is the appropriate code. If the procedure is limited to sequestrectomy of the shaft or distal humerus without the broader craterization/saucerization technique, 24134 may be more accurate — review the operative approach and technique carefully.
02Can 24140 be used for a tumor excision of the humerus?
Not for radical tumor resection. CPT 24140 is for partial excision using craterization or saucerization techniques, typically in the context of infection or abscess. Benign tumor excision or curettage of the humeral shaft maps to 24110 (with autograft: 24115, with allograft: 24116). Radical resection of a malignant tumor of the proximal humerus uses 23220. Match the code to the pathology and extent of resection documented.
03What modifier applies if the surgeon returns to the OR for wound debridement related to the original 24140 procedure within the 90-day global?
Use modifier 78 — unplanned return to the OR for a procedure related to the original surgery during the global period. Do not use modifier 79 for a related complication; 79 is reserved for unrelated procedures in the global window. Document clearly that the return visit was precipitated by a complication or sequela of the original excision.
04How does site of service affect reimbursement for 24140?
The HOPD and ASC facility payments differ considerably — see the Site of Service comparison table on this page. The physician's professional fee also carries a site-of-service differential under the CMS Physician Fee Schedule 2026, with a lower non-facility RVU when the case is performed in a facility setting. Confirm which setting is most economical for your patient population and payer mix before scheduling.
05If both humeri require partial excision in the same operative session, how should the claim be submitted?
Bill 24140 with modifier 50 for a bilateral procedure performed in a single session. Some payers instead require LT and RT on two separate lines with modifier 51 on the secondary. Check individual payer billing guidelines — Medicare accepts modifier 50 on a single line; many commercial payers follow the same convention but verify before submitting.
06Does a bone culture or intraoperative pathology specimen need to be documented for 24140 to pass medical necessity review?
Most payers expect evidence of infection or destructive pathology in the record — preoperative imaging showing bone destruction, prior failed antibiotic therapy, or prior positive cultures all strengthen the medical necessity case. An operative note that mentions removing bone with no supporting pathological indication is a common audit flag. Intraoperative culture or specimen submission, when obtained, should be noted in the operative report.

Sources & references

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

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    cms.gov
    https://www.cms.gov/files/document/2025nccimedicarepolicymanualcompletepdf.pdf
  3. 03
    emedny.org
    https://www.emedny.org/providermanuals/physician/pdfs/physician%20procedure%20codes%20sect5.pdf
  4. 04
    aapc.com
    https://www.aapc.com/codes/cpt-codes/24140
  5. 05
    eatonhand.com
    https://www.eatonhand.com/coding/n24140.htm

Mira AI Scribe

Mira's AI scribe captures the surgical technique (craterization, saucerization, or diaphysectomy), exact humeral location, laterality, extent of bone removed, and the pathological indication from the surgeon's dictation. That prevents the most common audit flag on 24140: operative notes that name the incision but not the bone-removal technique or defect size, which payers treat as insufficient documentation for the complexity billed.

See how Mira captures CPT 24140 documentation

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