Surgical · Elbow

Manipulation of the elbow joint performed while the patient is under anesthesia to improve range of motion or correct contracture.

Verified May 8, 2026 · 4 sources ↓

Medicare: $446.24
Total RVUs: 13.36
Global, days: 90
Region: Elbow

Drawn from CMSAAPCAAOS

Documentation requirements

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

Source · Editorial brief grounded in 4 cited references ↓

Diagnosis driving the procedure — specify the underlying cause of stiffness (post-traumatic contracture, post-surgical adhesions, OA, etc.) with corresponding ICD-10 code
Failed conservative treatment history — document duration and type of therapy attempted before proceeding to MUA
Pre-procedure range-of-motion measurements in degrees (flexion, extension, pronation, supination) to establish medical necessity
Post-procedure range-of-motion measurements documenting the motion gained during manipulation
Type and method of anesthesia administered and the name of the anesthesia provider
Laterality clearly stated (left, right, or bilateral) in both the operative note and the procedure order
If billing during another procedure's global period, documentation explicitly establishing that this condition is new or unrelated

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 58 Staged or related 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 AS PA/NP/CNS assistant

What this code covers

Source · Editorial summary grounded in 4 cited references ↓

CPT 24300 covers forcible manipulation of the elbow under general or regional anesthesia. The procedure is used when conservative therapy has failed to restore motion — most commonly after post-traumatic or post-surgical elbow stiffness, heterotopic ossification, or prolonged immobilization. Anesthesia allows complete muscle relaxation so the surgeon can break down adhesions and capsular contracture without pain-limited resistance.

The 90-day global period means all routine follow-up visits, supervised therapy check-ins billed by the same physician, and any repeat manipulation for the same condition fall inside the global window. If the patient develops an unrelated condition requiring a separate procedure during that period, append modifier 79. A planned staged repeat manipulation should carry modifier 58, which resets the global clock.

Site of service matters here: HOPD and ASC payments differ significantly (see the Site of Service comparison table). Bilateral elbow manipulation in the same session requires modifier 50 and payer pre-auth verification — bilateral presentation is uncommon and will draw scrutiny.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.94
Practice expense RVU	8.66
Malpractice RVU	0.76
Total RVU	13.36
Medicare national rate	$446.24
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	$446.24
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI G2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 24300 get rejected.

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

Missing pre-procedure ROM measurements — payers deny without objective baseline data supporting medical necessity
No documented trial of conservative therapy prior to MUA, failing medical necessity criteria
Laterality mismatch between the operative note and the claim — modifier LT or RT absent or inconsistent
Procedure billed during a prior surgery's global period without modifier 79 or 58, triggering a global period denial
Lack of anesthesia documentation or anesthesia provider not identified, causing facility or professional claim rejection

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 4 cited references ↓

01Does CPT 24300 carry a global period, and what does that include?

Yes — 24300 has a 90-day global period. That covers the surgery day, the day-before visit if applicable, and all routine post-op elbow follow-up by the same physician through day 90. Unrelated visits need modifier 24 (E/M) or 79 (procedure).

02Can 24300 be billed bilaterally?

Yes. Append modifier 50 when both elbows are manipulated in the same session. Expect the second side to reimburse at approximately 50% of the allowed amount. Payer pre-authorization is strongly recommended since bilateral elbow MUA is uncommon and will be scrutinized.

03What modifier applies if the patient needs a repeat elbow MUA during the global period?

If the repeat manipulation was planned as a staged treatment, use modifier 58 — it resets the global clock. If the return was unplanned due to a complication related to the original procedure, use modifier 78. Modifier 79 applies only if the new procedure is unrelated to the original.

04What ICD-10 codes are typically paired with 24300?

Common pairings include M24.521–M24.522 (contracture of elbow), M25.621–M25.622 (stiffness of elbow), and post-traumatic or post-surgical sequela codes. The ICD-10 must specifically reflect the condition treated, not just elbow pain — generic pain codes increase denial risk.

05How does site of service affect reimbursement for 24300?

HOPD and ASC payments differ materially — see the Site of Service comparison table on this page. The physician's professional fee also adjusts based on facility vs. non-facility setting. Most 24300 cases are performed in an ASC or hospital outpatient setting since anesthesia is required.

06Can an E/M visit be billed on the same day as 24300?

Only if the E/M addresses a separate, distinct problem unrelated to the elbow manipulation. Append modifier 25 to the E/M code and document the separate medical decision-making clearly. A routine pre-procedure assessment for the same condition is bundled into 24300.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures pre- and post-manipulation range-of-motion measurements in degrees, the specific indication (e.g., post-traumatic elbow contracture), the anesthesia type, and laterality directly from dictation. This prevents the most common denial trigger for 24300 — missing objective ROM data that payers require to adjudicate medical necessity.

See how Mira captures CPT 24300 documentation