Surgical removal of the elbow joint through open resection, typically performed for end-stage arthritic destruction, tumor, or chronic infection where joint-sparing procedures are no longer viable.

Verified May 8, 2026 · 5 sources ↓

Medicare: $791.27
Total RVUs: 23.69
Global, days: 90
Region: Elbow

Drawn from CMSCgsmedicareNovitas

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Operative note must identify all anatomic structures resected (distal humerus, proximal radius, proximal ulna) and extent of resection
Preoperative imaging (X-ray, CT, or MRI) confirming joint destruction or pathology necessitating resection
Explicit documentation of why joint-preserving or reconstructive alternatives were contraindicated or exhausted
Diagnosis linked to a specific ICD-10 code supporting medical necessity (e.g., end-stage arthritis, primary bone tumor, chronic osteomyelitis)
Implant log or pathology submission record if applicable to the resection indication
Postoperative plan documenting anticipated functional or rehabilitative goals

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 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 XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 24155 describes open resection of the elbow joint — a salvage-level procedure reserved for cases where the joint is unsalvageable by reconstruction, arthroplasty, or arthrodesis. Indications include severe post-traumatic or inflammatory arthritis with bone loss, periarticular tumors requiring wide resection, and refractory septic arthritis with joint destruction. The procedure removes some or all of the distal humerus, proximal radius, and/or proximal ulna articulating surfaces depending on pathology and surgical plan.

The 90-day global period covers all routine postoperative care through day 90. Any unrelated procedure performed during the global window requires modifier 79. A return to the OR for a complication related to the original resection — such as wound dehiscence or hardware removal — is reported with modifier 78. New E/M visits addressing conditions unrelated to the elbow resection during the global period require modifier 24.

Site of service matters significantly here: HOPD and ASC payment rates differ — see the Site of Service comparison table on this page. Payers will scrutinize medical necessity heavily for this code given its rarity; operative notes must clearly document why joint-preserving alternatives were not appropriate.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	11.79
Practice expense RVU	9.39
Malpractice RVU	2.51
Total RVU	23.69
Medicare national rate	$791.27
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	$791.27
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI J8) Ambulatory surgical center (freestanding)	$2,084.06

Common denial reasons

The recurring reasons claims for CPT 24155 get rejected.

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

Medical necessity not established — payer requires documented failure of conservative or joint-preserving treatment before approving resection
Operative note uses generic language ('elbow joint explored and resected') without specifying extent or structures removed
Incorrect global period billing — routine post-op visits billed separately without modifier 24 when unrelated, or missing modifier 79 for unrelated same-global procedures
Upcoded from a less extensive elbow procedure (e.g., 24100 or 24102) — resection must match documentation of actual tissue removed
Missing or inadequate preoperative imaging supporting irreparable joint destruction

Frequently asked questions

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

01What distinguishes 24155 from other elbow excision codes like 24100 or 24102?

24100 covers biopsy of the elbow joint and 24102 covers synovectomy. 24155 is specifically resection of the joint itself — meaning articular surface and/or bone removal constituting true joint resection, not just soft-tissue excision or biopsy.

02Can 24155 be billed bilaterally?

Bilateral elbow joint resection on the same day is extraordinarily rare and will trigger heavy scrutiny. If performed, append modifier 50 or use LT/RT on separate line items per payer preference, and ensure each side has independent operative documentation.

03Does the 90-day global include physical therapy ordered postoperatively?

No. PT is billed by the treating therapist under separate codes and is not included in the surgeon's global package. Only the surgeon's own postoperative management visits are bundled into the global.

04What modifier is needed if the patient returns to the OR within 90 days for an infected wound from the original resection?

Modifier 78 — unplanned return to the OR for a complication related to the original procedure. Do not use modifier 79, which is reserved for procedures unrelated to the original surgery.

05Should modifier 22 be appended for unusually difficult resections involving tumor or extensive bone loss?

Yes, if the work substantially exceeds typical resection complexity — for example, en bloc tumor resection with vascular or nerve involvement. Document operative time, complexity, and the specific factors that increased work. Payers require compelling operative note support to approve modifier 22 increased procedural services.

06What ICD-10 codes commonly support medical necessity for 24155?

Common supporting diagnoses include M19.021–M19.029 (primary osteoarthritis, elbow), M05.721–M05.729 (rheumatoid arthritis with involvement of elbow), C40.021–C40.029 (malignant neoplasm of bone, elbow), and M86 series for chronic osteomyelitis. The diagnosis must match the operative finding documented in the note.

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 extent from dictation — which articular surfaces were removed, approach used, and the clinical rationale ruling out joint-preserving alternatives. That detail closes the medical necessity gap that drives most denials on 24155. The scribe also flags the 90-day global start date so your team knows which modifier applies to any same-episode return visits.

See how Mira captures CPT 24155 documentation