Partial excision of the radial head or neck — removal of a portion of bone to address pathology without complete resection of the radial head.

Verified May 8, 2026 · 7 sources ↓

Medicare: $566.15
Work RVU: 7.61
Global, days: 90
Region: Elbow

Drawn from CMSAAOS

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Specify the exact anatomic location of bone removed — radial head versus radial neck, and the quadrant or extent of resection.
Document the pathology driving the partial excision: osteochondral defect, osteophyte, loose body, degenerative change, or post-traumatic deformity.
Describe why partial excision was chosen over complete radial head excision (24130) or radial head arthroplasty (24366) — i.e., extent of articular involvement and stability assessment.
Record intraoperative findings including cartilage condition, capitellar status, and ligamentous integrity to support medical necessity.
Note the surgical approach (lateral, posterolateral Kocher, or other) and any associated procedures performed at the same operative setting.
Document preoperative imaging (X-ray, CT, or MRI) that correlates with operative findings and supports the diagnosis codes used.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 62 Co-surgeons 74 Discontinued post-anesthesia 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 24145 covers partial excision of the radial head or neck, typically performed to address osteochondral defects, loose bodies, synovial impingement, or early degenerative changes where complete radial head excision (24130) or radial head arthroplasty (24366) is not yet indicated. The surgeon removes a defined portion of bone — most commonly a portion of the articular surface or a prominent osteophyte — to restore motion, reduce impingement, or decompress the radiocapitellar joint.

This carries a 90-day global period. That means the pre-op visit the day before surgery, the procedure itself, and all routine follow-up through postoperative day 90 are bundled. Separate E/M visits within the global window require modifier 24 for unrelated problems or modifier 25 for a significant, separately identifiable service on the same day as a minor procedure decision visit. Return trips for wound issues or implant adjustments that are unplanned and related to the original surgery bill with modifier 78; unrelated procedures in the global window use modifier 79.

The site of service gap is substantial — HOPD reimbursement significantly exceeds ASC payment under CMS Physician Fee Schedule 2026 (see the Site of Service comparison table). For practices with the option, this distinction directly affects facility negotiation strategy and case scheduling decisions.

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 (7.61) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (16.95) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	7.61
Practice expense RVU	7.71
Malpractice RVU	1.63
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 5114) Hospital outpatient department	$7,413.38
ASC (PI A2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 24145 get rejected.

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

Insufficient documentation of why partial rather than complete excision was performed — payers need rationale to confirm code selection is appropriate.
Diagnosis code mismatch: billing 24145 with a fracture-specific ICD-10 code when a traumatic fracture excision would map to a different CPT family.
Bundling conflict when 24145 is billed same-day with elbow arthroscopy or other elbow procedures without a modifier to establish separate service identity.
Lack of preoperative imaging documentation, causing reviewers to question medical necessity for operative intervention.
Global period overlap when a second elbow procedure is billed within 90 days without modifier 78 or 79 to clarify the relationship to the index surgery.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What is the difference between CPT 24145 and CPT 24130?

24130 is complete radial head excision; 24145 is partial excision of the radial head or neck. The operative note must document the extent of bone removed and explain why the partial approach was clinically appropriate. Billing 24145 when the entire radial head was removed is a misrepresentation.

02Can 24145 be billed with elbow arthroscopy on the same day?

It depends on how the procedures relate. If arthroscopy (e.g., 29836 or 29837) and 24145 are both performed, NCCI edits may apply. Check the current NCCI PTP table for the specific code pair. If they are separately identifiable and meet the criteria, modifier 59 or XS may be needed to bypass the edit, along with documentation supporting distinct services.

03What modifier applies if the patient returns to the OR within the 90-day global for a related elbow complication?

Modifier 78 — unplanned return to the operating room for a procedure related to the original surgery during the global period. Do not use modifier 79, which is reserved for unrelated procedures in the global window.

04Which ICD-10 codes most commonly support medical necessity for 24145?

Common diagnoses include osteochondritis dissecans of the elbow (M93.221–M93.222), primary osteoarthritis of the elbow (M19.021–M19.022), loose body in the elbow joint (M24.071–M24.072), and post-traumatic deformity following radial head fracture. The diagnosis must match operative findings documented in the note.

05Does the 90-day global period reset if a staged procedure is planned?

Yes. If a staged related procedure — such as a planned conversion to radial head arthroplasty — is performed during the original global window by the same surgeon, append modifier 58. This signals the second procedure was planned or staged, and it resets the global period clock from the date of the second operation.

06Is modifier 22 ever appropriate for 24145?

Yes, when the procedure is substantially more complex than typical — for example, severe post-traumatic deformity, dense scar tissue from prior surgery, or unusually prolonged operative time. The operative note must explicitly describe the increased complexity, and you should attach a cover letter to the claim explaining the circumstances.

07How does site of service affect reimbursement for 24145?

HOPD payment significantly exceeds ASC payment under CMS Physician Fee Schedule 2026. For practices that can schedule cases in either setting, site of service affects total facility revenue. The surgeon's professional fee is the same regardless of site; the gap is in the facility payment.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the operative dictation elements that matter most for 24145: the anatomic extent of bone removed (head vs. neck, which quadrant), the pathology encountered, the surgeon's intraoperative rationale for partial rather than complete excision, capitellar and ligamentous status, and the named surgical approach. That specificity prevents the most common audit flag on this code — an operative note that describes a resection without documenting why it stopped short of a complete radial head excision or arthroplasty.

See how Mira captures CPT 24145 documentation