Soft tissue repair · Elbow

24310

Open surgical release of a tendon anywhere from the elbow to the shoulder region, reported once per tendon released.

Verified May 8, 2026 · 6 sources ↓

Medicare
$442.23
Work RVU
5.97
Global, days
90
Region
Elbow
Drawn from CMSBedrockbillingMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

  • Identify the specific tendon(s) released by name (e.g., biceps long head, triceps, common extensor origin)
  • Document the surgical approach — medial, lateral, posterior, or anterior — not just 'standard'
  • Record conservative treatment attempts and duration to establish medical necessity
  • Confirm laterality (left vs. right) in both the operative note and the procedure order
  • If multiple tendons released, document each tendon separately to support additional units with modifier 51
  • Pre-op diagnosis with ICD-10 linkage tying the specific tendon pathology to the procedure performed

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 6 cited references ↓

CPT 24310 covers an open tenotomy of any tendon in the elbow-to-shoulder segment — biceps, triceps, or other regional tendons — when conservative management has failed and surgical release is required. The code is reported per tendon, so if two tendons are released in the same operative session, you report 24310 twice with modifier 51 on the second unit.

The 90-day global period means all routine follow-up care through day 90 is bundled into the surgical payment. Separate E/M visits within that window require modifier 24 (unrelated condition) or modifier 79 (unrelated procedure). An unplanned return to the OR for a related complication gets modifier 78; an unrelated same-physician procedure in the global window gets modifier 79.

Site of service matters here: HOPD and ASC payments differ substantially (see the Site of Service comparison table). Verify that the facility is enrolled correctly and that your operative note specifies the exact tendon(s) released and the surgical approach — vague notes like 'elbow tendon released' are a fast path to a medical review request.

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 (5.97) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (13.24) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU 5.97
Practice expense RVU 6.12
Malpractice RVU 1.15
Total RVU 13.24
Medicare national rate $442.23
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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$442.23
HOPD (APC 5113)
Hospital outpatient department
$3,342.87
ASC (PI A2)
Ambulatory surgical center (freestanding)
$1,644.87

Common denial reasons

The recurring reasons claims for CPT 24310 get rejected.

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

  • Operative note fails to name the specific tendon, triggering medical necessity denial
  • Missing documentation of failed conservative care before surgical intervention
  • Second tendon unit denied when modifier 51 is absent on the additional 24310 line
  • Global period violation — post-op E/M billed without modifier 24 or 25
  • Laterality missing or conflicting between the claim and the operative report
  • Bundling denial when a component service (e.g., local anesthesia by the surgeon) is billed separately

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Can 24310 be reported more than once in the same surgical session?
Yes. The code is defined per tendon. Bill a second unit of 24310 with modifier 51 for each additional tendon released in the same session. Document each tendon by name in the operative report.
02What modifier applies when 24310 is performed bilaterally?
Use modifier 50 for a true bilateral procedure performed in the same session. Alternatively, report 24310-LT and 24310-RT as separate line items depending on payer preference — confirm with the specific payer before submitting.
03How long is the global period for 24310, and what's included?
24310 carries a 90-day global. It includes the day-before pre-op visit, the surgery itself, and all routine post-op care through day 90. Complications and related follow-up are bundled; unrelated conditions need modifier 24 on the E/M.
04Does 24310 require modifier 59 when billed with other elbow or shoulder codes?
Only if NCCI bundles the paired code and a distinct anatomic site or separate structure justifies the additional service. Check the NCCI PTP edits for the specific code pair. Modifier XS is appropriate when the second procedure is on a truly separate structure.
05What ICD-10 codes typically support medical necessity for 24310?
Commonly paired diagnoses include tendinopathy (M77.x series for lateral/medial epicondyle), biceps tendon disorders (M66.x, M75.2x), and post-traumatic tendon contracture. The diagnosis must be tendon-specific and match the operative note.
06Is modifier 22 ever appropriate for 24310?
Yes, when the procedure is substantially more work than typical — severe scarring, revision after prior surgery, or unusually complex anatomy. Attach an operative note that explicitly quantifies the additional time and effort; without it, the modifier 22 request will be denied.

Mira AI Scribe

Mira's AI scribe captures the tendon name, surgical approach, laterality, and pre-operative diagnosis directly from your dictation for 24310. It flags when the note lacks a named tendon or omits documentation of prior conservative treatment — the two documentation gaps most likely to trigger a medical necessity denial or post-payment audit.

See how Mira captures CPT 24310 documentation

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