Tenodesis of the biceps tendon at the elbow, performed as a separate procedure — anchoring the tendon end to bone at the elbow joint.

Verified May 8, 2026 · 7 sources ↓

Medicare: $583.51
Work RVU: 7.88
Global, days: 90
Region: Elbow

Drawn from CMSAAPCFaculty

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Operative note must specify tenodesis — not just 'biceps repair' — and identify the fixation method (suture anchor, interference screw, bone tunnel).
Document the anatomic location of fixation explicitly; 'at the elbow' is insufficient if the note could support 24342 instead.
Indicate whether this was a standalone procedure or performed in conjunction with another elbow surgery, since the 'separate procedure' designation affects billing logic.
Record the indication: degenerative tendinopathy, partial tear, or other pathology that drove the tenodesis rather than acute rupture reinsertion.
Note anesthesia type and patient positioning to support medical necessity and surgical complexity if modifier 22 is considered.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 51 Multiple procedures 59 Distinct service 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 24340 describes surgical fixation of the biceps tendon to bone at the elbow — a tenodesis. The surgeon secures the tendon using sutures, anchors, or interference screws, restoring mechanical continuity without the full reinsertion implied by adjacent codes. The parenthetical 'separate procedure' designation matters: it signals that 24340 is routinely bundled when performed alongside a more comprehensive elbow procedure, but can be billed independently when it stands alone as the primary intervention.

Distinguishing 24340 from its neighbors is a persistent coding challenge. 24342 (reinsertion of ruptured distal biceps or triceps tendon) applies to acute rupture with reattachment at the radial tuberosity — a fundamentally different construct. 24341 covers tendon repair more broadly. If the operative note describes reinsertion of a ruptured distal biceps at the radial tuberosity, 24342 is the correct code; 24340 fits when the surgeon is performing a tenodesis at the elbow without the acute-rupture reinsertion context. Audit risk is highest when coders use these interchangeably without reading the operative note for anatomic specificity.

The 90-day global period applies. All routine elbow follow-up, splint changes, and wound checks through day 90 are bundled. Use modifier 24 for unrelated E&M visits in that window, modifier 78 for an unplanned return to the OR for a related complication, and modifier 79 for an unrelated procedure during the global.

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 (7.88) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (17.47) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	7.88
Practice expense RVU	7.97
Malpractice RVU	1.62
Total RVU	17.47
Medicare national rate	$583.51
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	$583.51
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 24340 get rejected.

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

Code billed as bundled component of a more comprehensive elbow procedure without an appropriate modifier to unbundle.
Payer downcodes to 24341 or 24342 when the operative note lacks tenodesis-specific language or fixation detail.
Missing or insufficient medical necessity documentation — no imaging, exam findings, or conservative treatment failure noted in the record.
Global period conflict: post-op E&M or minor procedure billed without modifier 24 or 79 within the 90-day window.

Frequently asked questions

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

01What is the difference between 24340 and 24342?

24342 is for reinsertion of a ruptured distal biceps tendon — typically an acute tear reattached at the radial tuberosity. 24340 is a tenodesis at the elbow, anchoring the tendon to bone in a non-reinsertion context. The operative note must support which scenario occurred; using these interchangeably is a common audit trigger.

02Why does 24340 say 'separate procedure' in the descriptor?

The 'separate procedure' parenthetical means 24340 is typically bundled when performed as a component of a larger elbow surgery. It is billed independently only when it is the primary, standalone procedure. If billed alongside another elbow code, expect a bundling edit unless a modifier is supported.

03Can 24340 be billed same-day as an E&M visit?

Yes, if the E&M is significant and separately identifiable. Append modifier 25 to the E&M. Document a distinct decision-making process beyond the pre-procedure assessment in the same note.

04What modifier applies if the patient returns to the OR for a complication within the 90-day global?

Use modifier 78 for an unplanned return to the OR for a complication related to the original tenodesis. Use modifier 79 if the return procedure is unrelated to 24340. Do not use these interchangeably — payers audit the distinction.

05Is there a site-of-service payment difference for 24340?

Yes. HOPD and ASC payments differ materially — see the Site of Service comparison table on this page. For elective cases in stable patients, ASC is the lower-cost setting, which some payers incentivize or require.

06When is modifier 22 justified for 24340?

Modifier 22 applies when the procedure is substantially more complex than typical — for example, significant scarring from prior surgery, unusually difficult anatomy, or markedly extended operative time. Document the specific factors in the operative note; payers require supporting narrative, not just the modifier.

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 surgeon's dictated fixation technique (anchor type, suture configuration, bone tunnel vs. cortical button), the anatomic attachment site at the elbow, and the clinical indication driving the tenodesis. That specificity prevents downcoding to 24341 or miscoding as 24342, the two most common audit flags for this code family.

See how Mira captures CPT 24340 documentation