Soft tissue repair · Elbow

24301

Surgical transfer of one or more muscles or tendons in the upper arm or elbow to restore lost motor function.

Verified May 8, 2026 · 5 sources ↓

Medicare
$700.75
Total RVUs
20.98
Global, days
90
Region
Elbow
Drawn from CMSAAPCMdclarityEmedny

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 the specific muscle or tendon transferred by anatomic name — 'tendon transfer' alone is insufficient.
  • Document the donor muscle/tendon origin and its new insertion site with the fixation technique used (suture anchor, tenodesis, weave).
  • Indicate the underlying diagnosis driving the transfer — nerve injury level, palsy type, or prior surgical failure — to justify medical necessity.
  • Record preoperative motor strength grades for both the donor and recipient muscle groups to establish baseline and necessity.
  • Note whether tourniquet was used, operative positioning, and any intraoperative nerve monitoring if applicable.
  • If additional procedures were performed at the same session, document that each was distinct and not integral to the transfer itself.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 24301 covers a single muscle or tendon transfer at the upper arm or elbow — repositioning a functioning motor unit to compensate for paralysis, nerve injury, or irreparable tendon loss. The transferred structure is detached from its origin or insertion, rerouted, and secured to a new attachment point to restore active motion the patient has lost. Common indications include radial nerve palsy, posterior interosseous nerve injury, brachial plexus sequelae, and post-traumatic or post-infectious motor deficits.

The 90-day global period means all routine follow-up — splinting, wound checks, suture removal, and early therapy coordination visits — is bundled. Bill a second distinct procedure on the same operative session with modifier 51. If the surgeon performs a second, separately distinct tendon transfer at the same site, evaluate whether 24301 can be reported twice with modifier 59 or whether an add-on or unlisted code is more appropriate based on payer policy.

This code sits in the reconstruction and repair family for the humerus and elbow (CPT range 24300–24356). It is distinct from tendon repair (24357–24359) and from tenolysis or tendon lengthening, which have their own descriptors. Selecting the wrong family is the most common upcoding flag auditors look for in elbow soft-tissue cases.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU10.12
Practice expense RVU8.75
Malpractice RVU2.11
Total RVU20.98
Medicare national rate$700.75
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
$700.75
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 24301 get rejected.

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

  • Operative note lacks the specific tendon or muscle name, triggering a medical necessity or specificity denial.
  • Payer bundles 24301 with a same-day nerve repair or decompression code when modifier 59 is absent or unsupported by documentation.
  • Missing preoperative functional assessment means the payer cannot confirm the transfer was not redundant to preserved motor function.
  • Prior authorization not obtained for elective reconstructive tendon transfer cases, particularly under commercial and Medicaid plans.
  • Global period conflict: post-op E/M visits billed without modifier 24 when the visit reason is not clearly unrelated to the transfer.

Frequently asked questions

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

01Does 24301 cover multiple tendon transfers in the same operative session?
24301 describes a single transfer. If you perform two distinct tendon transfers at the upper arm or elbow during the same session, report 24301 twice with modifier 51 on the second unit, and confirm each is documented as a separate procedure with its own donor and recipient anatomy. Some payers require modifier 59 instead of or in addition to 51 — check your MAC's policy.
02What is the global period for 24301 and what does it include?
24301 carries a 90-day global. That covers the day before surgery, the procedure itself, and all routine post-op visits through day 90 — including wound checks, splint or cast management, and stitch removal. Therapy referrals are not separately billable by the surgeon during the global. Anything genuinely unrelated to the transfer requires modifier 24 on the E/M.
03Can 24301 be billed with a nerve repair code on the same day?
Yes, if the nerve repair is a separately identifiable procedure and not merely incidental to the tendon transfer approach. Use modifier 59 (or XS if the payer accepts X-modifiers) on the secondary code and ensure the operative note documents distinct surgical steps for each procedure. NCCI edits may bundle certain nerve codes — verify the specific pair against the current NCCI table.
04What diagnoses most commonly support medical necessity for 24301?
Radial nerve palsy (ICD-10 G54.2, S54.2xx), posterior interosseous nerve injury, brachial plexus lesions, and post-traumatic or post-infectious motor loss at the elbow are the primary drivers. Document the motor deficit grade and failed conservative management or irreversibility of the neural lesion to clear medical necessity review.
05How does site of service affect reimbursement for 24301?
There is a meaningful payment difference between the hospital outpatient department and the ASC setting — see the Site of Service comparison table on this page. The physician professional fee also differs based on facility vs. non-facility practice expense RVUs. Performing 24301 in a non-facility setting (office procedure room) is rare given the surgical complexity, but if billed, the non-facility RVU applies.
06Is modifier 22 ever appropriate for 24301?
Yes, when the transfer is substantially more complex than typical — for example, severe scarring from prior surgeries, revision after failed primary transfer, or unusually difficult anatomy requiring extended operative time. Attach a cover letter quantifying additional time and complexity. Without that documentation, most payers will ignore modifier 22 and pay the standard rate.

Mira AI Scribe

Mira's AI scribe captures the transferred structure by anatomic name, the donor origin, the new insertion site, fixation method, and the functional deficit driving the case — all from intraoperative dictation. That specificity prevents the single most common 24301 denial: an operative note that says 'tendon transfer performed' without identifying what moved or where it went.

See how Mira captures CPT 24301 documentation

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