Surgical · Elbow

Radical resection of a tumor involving the distal or shaft portion of the humerus, with or without allograft reconstruction.

Verified May 8, 2026 · 7 sources ↓

Medicare: $1,397.16
Total RVUs: 41.83
Global, days: 90
Region: Elbow

Drawn from CMSCgsmedicareAAPC

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Pathology or imaging diagnosis specifying tumor type, location (distal humerus vs. humeral shaft), and size — required to justify radical vs. curettage approach
Operative note must document en-bloc wide-margin resection technique, not simple excision or curettage; vague language like 'standard resection' flags audits
If allograft reconstruction is performed, document allograft type, size, and source in the operative note to support 20932 billing
Preoperative imaging (MRI, CT, or bone scan) in the record confirming tumor extent and surgical planning
Margin status documented — intraoperative frozen section or final pathology noting margins supports medical necessity for the radical approach
ICD-10 diagnosis code must specify bone tumor type and laterality (e.g., C40.02 for malignant neoplasm, distal humerus)

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 58 Staged or related 62 Co-surgeons 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 7 cited references ↓

CPT 24150 describes radical resection of a tumor at the distal humerus or humeral shaft — an aggressive, wide-margin bone resection performed for primary bone tumors such as giant cell tumor, osteosarcoma, or other aggressive lesions requiring en-bloc removal. The procedure removes the involved bone segment along with a surrounding cuff of normal tissue, and may include allograft reconstruction of the resected segment. The distinction from simple excision or curettage codes (e.g., 24110, 24115) is the radical, wide-margin intent: this is oncologic surgery, not a benign lesion cleanup.

The 90-day global period applies. That window covers the preoperative day-before visit, the surgery itself, and all routine postoperative care through day 90 — including wound checks, drain management, and casting or splinting related to the resection. Any E&M visit for a problem unrelated to the resection during the global period must carry modifier 24. A planned staged procedure (e.g., allograft revision) within the 90-day window requires modifier 58; an unplanned return to the OR for a related complication requires modifier 78.

CPT 20932 (allograft, structural, for use with a primary tumor resection) is a reportable add-on when a structural allograft is used — and per CPT Code First instructions, 24150 is an explicitly listed primary code for 20932. Verify NCCI edits before stacking additional codes; payers including Aetna have been known to bundle ancillary implant removal codes (e.g., 11981) into this service without modifier override.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	22.87
Practice expense RVU	14.09
Malpractice RVU	4.87
Total RVU	41.83
Medicare national rate	$1,397.16
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	$1,397.16
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI G2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 24150 get rejected.

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

Operative note describes curettage or intralesional excision, contradicting the radical resection code billed
Missing or mismatched diagnosis — ICD-10 code reflects benign lesion without documented clinical rationale for radical margin approach
NCCI bundling conflict when additional component codes are billed without an appropriate modifier to bypass the edit
Lack of preoperative imaging or pathology in the record, failing to establish medical necessity for oncologic-level resection
Allograft add-on (20932) denied because primary code is not documented as the base code or the allograft source and type are not specified

Frequently asked questions

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

01Can I bill 20932 alongside 24150 for allograft reconstruction?

Yes. CPT explicitly lists 24150 as a primary code for add-on code 20932 (structural allograft for tumor resection). Document allograft type, size, and source in the operative note. Do not also bill bone graft codes that describe the same graft material — that's a bundling conflict.

02What's the difference between 24150 and 24110 or 24115?

24110 and 24115 describe excision or curettage of a bone cyst or benign tumor of the humerus — intralesional or marginal approaches. 24150 is radical resection with wide margins for aggressive or malignant tumors. The operative technique and margin intent must match the code billed; using 24150 for a curettage is an audit risk.

03Does the 90-day global period affect how I bill postoperative complications?

Related postoperative visits and minor interventions are bundled into the global through day 90. An unplanned return to the OR for a related problem (e.g., wound dehiscence at the resection site) bills with modifier 78. An unrelated procedure during the global period requires modifier 79. Do not invert those two modifiers — it's a common and auditable error.

04Is modifier 50 appropriate if tumor resection is performed bilaterally?

Bilateral humeral tumor resection on the same day is rare, but modifier 50 would apply if both arms are treated in the same session. Confirm payer-specific bilateral payment rules — some commercial payers reduce payment to 150% of the single-procedure rate; Medicare follows the same convention. Document separate tumor pathology and surgical necessity for each side.

05How do I bill a staged reconstruction within the 90-day global of 24150?

A planned staged procedure — such as prosthetic conversion or allograft revision after initial resection — uses modifier 58 to indicate it was staged or planned. Modifier 58 reopens a new global period. An unplanned return for a related complication uses modifier 78 instead, which does not start a new global.

06Aetna is bundling 11981 into 24150 and denying it — is that correct?

Aetna has a payer-specific policy bundling implantable drug delivery device removal (11981) into 24150 and similar tumor resection codes, even where NCCI does not have a PTP edit requiring it. Check the payer's specific coverage policy and consider a modifier with supporting documentation. Medicare NCCI does not have a mandatory bundling edit for this pair, but commercial payer policies vary.

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 resection margin approach (wide/en-bloc vs. intralesional), tumor location on the humerus (distal vs. shaft), allograft use and type, and intraoperative margin assessment from the surgeon's dictation. This prevents the most common denial for 24150: an operative note that reads like a curettage when a radical resection was coded — a mismatch that draws both payer denial and RAC audit flags.

See how Mira captures CPT 24150 documentation