Surgical repair of a tendon or muscle in the upper arm or elbow region, reported once per structure repaired.

Verified May 8, 2026 · 6 sources ↓

Medicare: $708.10
Total RVUs: 21.2
Global, days: 90
Region: Elbow

Drawn from CMSAAPCMdclarityCgsmedicareAAOS

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 or muscle repaired by name (e.g., distal biceps, triceps, brachialis)
Document the surgical technique: primary end-to-end repair, bone tunnel reinsertion, suture anchor fixation, or graft augmentation
Specify laterality (left or right upper arm/elbow) in the operative note and on the claim
If billing multiple units for multiple structures, document each structure as a separately identified repair with its own intraoperative findings
Record mechanism of injury or clinical indication supporting the medical necessity of open repair over non-surgical management
Note whether the repair was performed in an acute or chronic/revision setting, as this affects modifier 22 justification

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 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 80 Assistant surgeon AS PA/NP/CNS assistant 62 Co-surgeons

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 24341 covers open repair of a tendon or muscle in the upper arm or elbow. The code is reported per structure — if two separate tendons are repaired at the same operative session, bill 24341 twice with modifier 51 on the second unit. This is a unilateral code; use LT/RT to lateralize, or modifier 50 for bilateral procedures performed in the same session.

The 90-day global period means all routine follow-up, wound checks, and suture removal through day 90 are bundled. Unrelated E/M services during the global window require modifier 24. A new problem or complication requiring a separately identifiable decision needs modifier 25 if addressed at a pre-op same-day visit, or modifier 78 if it requires an unplanned return to the OR for a related issue.

Common clinical indications include distal biceps tendon ruptures repaired at the elbow, triceps tendon tears, and proximal muscle avulsions in the upper arm. Document the specific structure repaired, the technique used, and whether the repair was primary or involved augmentation — auditors will scrutinize operative notes that lack structure-level specificity.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	9.25
Practice expense RVU	10.12
Malpractice RVU	1.83
Total RVU	21.2
Medicare national rate	$708.10
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	$708.10
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 24341 get rejected.

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

Operative note names the anatomic region but not the specific tendon or muscle repaired, failing medical necessity review
Multiple units billed without modifier 51 or without documentation identifying each structure as a distinct repair
Laterality modifier (LT or RT) missing, triggering claim suspension or automated denial at many payers
Global period conflict: post-op E/M billed without modifier 24, flagged as bundled service
Code selected without supporting a diagnosis code that maps to an upper arm or elbow tendon/muscle pathology — ICD-10 mismatch triggers automated denial

Frequently asked questions

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

01Can I bill 24341 twice if I repaired two separate tendons in the same elbow during one surgery?

Yes. Report 24341 for each structure repaired. Append modifier 51 to the second (and any additional) unit to indicate multiple procedures in the same session. Document each tendon or muscle as a distinct finding and repair in the operative note.

02What's the correct modifier when the same repair is needed on both elbows in one session?

Use modifier 50 for professional claims to indicate a bilateral procedure. For ASC facility claims, bill two lines with LT on one and RT on the other, each with one unit of service, per CMS NCCI billing policy.

03Is 24341 appropriate for distal biceps tendon repair at the elbow?

Yes. Distal biceps repair at the elbow falls within the upper arm/elbow anatomic scope of 24341. Document the insertion-site technique (e.g., suture anchor, bone tunnel, EndoButton) and confirm the operative note names the distal biceps specifically.

04What modifier covers an unplanned return to the OR during the 90-day global for a re-rupture of the repaired tendon?

Modifier 78 — unplanned return to the OR for a complication or related condition during the global period. Do not use modifier 79 (unrelated procedure) for a re-rupture of the same structure.

05When is modifier 22 justified on 24341?

Modifier 22 is supported when documented intraoperative findings significantly increase operative complexity — for example, severe scarring from prior surgery, a chronic retracted tear requiring graft augmentation, or an unusually prolonged repair. The operative note must describe what made the work atypical; 'difficult anatomy' alone won't clear payer review.

06Does CPT 24341 include intraoperative fluoroscopy or imaging?

Per NCCI policy, if fluoroscopy is used as a guidance adjunct integral to the repair technique, it is not separately reportable. If imaging is used for a separate, distinct service at the same encounter, review whether a modifier-eligible NCCI edit exists before billing an imaging code alongside 24341.

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 specific tendon or muscle name, repair technique, laterality, and whether the procedure was primary or revision directly from dictation. That structure-level detail prevents the most common audit flag on 24341 — operative notes that describe an elbow repair without naming the repaired structure — and ensures laterality modifiers populate automatically on the claim.

See how Mira captures CPT 24341 documentation