Soft tissue repair · Elbow

24342

Reinsertion of a ruptured distal biceps or triceps tendon at the elbow, with or without tendon graft (graft harvest included when performed).

Verified May 8, 2026 · 7 sources ↓

Medicare
$716.12
Total RVUs
21.44
Global, days
90
Region
Elbow
Drawn from CMSAAPCCgsmedicareEatonhand

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

  • Identify the specific tendon repaired (distal biceps or distal triceps) and confirm rupture versus partial tear
  • Document the fixation technique by name (e.g., cortical button, suture anchor, transosseous tunnels) — 'standard repair' is an audit flag
  • State whether a tendon graft was used and, if so, the graft source (autograft, allograft) and harvest site
  • Record laterality (right vs. left elbow) explicitly in both the operative note and the postoperative diagnosis
  • Note the surgical approach (single-incision vs. two-incision technique) and any neurovascular findings
  • Capture pre-op imaging or clinical findings confirming complete rupture to support medical necessity

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 7 cited references ↓

CPT 24342 covers surgical reinsertion of a ruptured distal biceps or triceps tendon at the elbow. The code applies to both tendons distally and includes tendon graft harvest when a graft is used — you don't bill a separate graft-procurement code. Common techniques include single- or double-incision repair with suture anchors or cortical button fixation; document the specific technique and fixation method by name in the operative note.

The 90-day global period means all routine post-op care from the day of surgery through day 90 is bundled. Separate E/M visits within that window require modifier 24 (unrelated condition) or modifier 25 (separate significant evaluation on the same day as a procedure). A staged or unplanned return to the OR for the same tendon repair within the global carries modifier 78; an unrelated procedure in that window uses modifier 79.

Laterality modifiers (LT/RT) are required on every claim — payers routinely deny elbow surgery claims missing laterality. If a concomitant ulnar nerve transposition (64718) is performed, NCCI bundles it with adjacent elbow soft-tissue work; append modifier 59 or XS with documentation showing a distinct indication and separate operative effort.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU10.59
Practice expense RVU8.74
Malpractice RVU2.11
Total RVU21.44
Medicare national rate$716.12
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
$716.12
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 24342 get rejected.

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

  • Missing laterality modifier — claims for elbow surgery without LT or RT are routinely rejected by commercial and Medicare payers
  • Billing a separate tendon graft procurement code when graft harvest is already included in 24342
  • Using 24342 when the operative note describes a partial repair or tendon debridement without true reinsertion — consider 24341 if reinsertion was not performed
  • E/M visit billed within the 90-day global without modifier 24 or 25, triggering a global-period denial
  • NCCI bundling denial when 64718 (ulnar nerve transposition) is billed same-day without modifier 59 or XS and supporting documentation

Frequently asked questions

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

01Does 24342 cover both distal biceps and distal triceps repairs?
Yes. The code applies to reinsertion of either a ruptured distal biceps or distal triceps tendon at the elbow. Orthopedic surgeons always repair triceps distally, so 24342 is the correct primary code. Alternatively, 24341 may apply if the repair does not involve reinsertion.
02Is tendon graft harvest billed separately when using 24342?
No. Graft harvest — including obtaining the graft — is included in 24342 when a graft is used. Billing a separate graft procurement code alongside 24342 is incorrect unbundling and will be denied.
03Can I bill a same-day E/M with 24342?
Only if the E/M addresses a separate condition unrelated to the tendon repair. Append modifier 25 if the decision for surgery was made that same day during a significant evaluation. Within the 90-day global, post-op E/M visits for the repair itself are bundled — use modifier 24 only for a truly unrelated problem.
04How do I handle a same-day ulnar nerve transposition billed with 24342?
NCCI bundles 64718 (ulnar nerve transposition at the elbow) with adjacent elbow procedures. If the transposition is medically distinct and separately documented, append modifier 59 or XS to 64718. Your operative note must clearly support a separate indication and discrete operative effort.
05What modifier applies if the patient returns to the OR within the global period for the same tendon?
Use modifier 78 for an unplanned return to the OR during the global period for a complication or issue related to the original distal biceps or triceps repair. Modifier 79 applies only if the return procedure is unrelated to the original tendon repair.
06Is 24342 appropriate when the surgeon opened the arm but could not locate or retrieve the retracted tendon?
No. If the tendon was not reinserted, 24342 does not apply. In that scenario, bill the exploration with the most appropriate unlisted or alternative code and document the operative findings thoroughly to support the service rendered.
07What is the global period for 24342, and what does it include?
24342 carries a 90-day global period. That covers the day-of and day-before pre-op visit, the procedure itself, and all routine post-op care through day 90 — including wound checks, splint or cast changes, and suture removal. Anything outside routine post-op care or unrelated to the repair needs the appropriate modifier to bill separately.

Mira AI Scribe

Mira's AI scribe captures the tendon name (biceps vs. triceps), confirmation of complete distal rupture, fixation technique (e.g., cortical button, suture anchor), graft use and harvest site, surgical approach (single vs. two-incision), and laterality from dictation. That specificity prevents the two most common denials: wrong-code disputes when the op note is vague about reinsertion vs. repair, and laterality rejections when side isn't clearly documented.

See how Mira captures CPT 24342 documentation

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