Surgical reconstruction of the lateral collateral ligament of the elbow using a tendon graft, including harvesting of the graft from the patient.

Verified May 8, 2026 · 5 sources ↓

Medicare: $1,030.42
Total RVUs: 30.85
Global, days: 90
Region: Elbow

Drawn from CMSAAPCAbos

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Specify the ligament by name or accepted abbreviation (LCL, RCL) and confirm it is the lateral — not medial — side.
Document why primary repair with local tissue was insufficient (retracted ligament, diseased tissue, friable tissue, gap/instability).
Identify the graft type and harvest site; the operative note must confirm graft harvesting occurred as part of this procedure.
Record the surgical approach by name — do not use 'standard approach' without further description.
Document pre-operative instability findings and clinical indication supporting reconstruction over repair.
Note any concomitant procedures performed and the rationale for each if billing additional codes same-day.

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 25 Significant separate E/M 51 Multiple procedures 57 Decision for surgery 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 24344 describes open reconstruction of the elbow's lateral collateral ligament (LCL) — also documented as the radial collateral ligament (RCL) — using a tendon graft. The code includes harvesting of the graft, so graft harvest is not separately billable. Use 24344 when the surgeon goes beyond local tissue repair: the ligament was retracted, diseased, or too friable to hold a primary repair, requiring a graft-based reconstruction. When the surgeon uses only local tissue without a graft, report 24343 instead.

Distinguishing 24343 from 24344 hinges entirely on graft use. Look for the word 'graft' in the operative report, or for clinical language indicating the native ligament could not be primarily repaired. Surgeons often document 'RCL' or 'LCL' rather than the full anatomical name — either abbreviation points to the lateral side. The medial equivalents are 24345 (repair) and 24346 (reconstruction with graft); do not confuse lateral and medial when selecting between these four codes.

The global period is 90 days. All routine post-op visits, wound care, and stitch removal through day 90 are bundled. Bill separate E&M services within the global period only with modifier 24 (unrelated condition) or 25 (significant, separately identifiable E&M on the day of the procedure). An unplanned return to the OR for a related problem during the global period requires modifier 78; an unrelated return-to-OR procedure requires modifier 79.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	14.83
Practice expense RVU	12.86
Malpractice RVU	3.16
Total RVU	30.85
Medicare national rate	$1,030.42
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	$1,030.42
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI J8) Ambulatory surgical center (freestanding)	$4,868.49

Common denial reasons

The recurring reasons claims for CPT 24344 get rejected.

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

Operative report does not mention a tendon graft — payer downcodes to 24343 (local tissue repair).
Graft harvest billed separately when it is already included in 24344.
Lateral and medial ligament codes confused — 24346 (medial reconstruction) billed when documentation clearly describes the lateral side.
Routine post-op E&M visits billed without modifier 24 or 25 during the 90-day global period.
Missing documentation of why primary repair was not viable, triggering medical necessity denials for reconstruction.

Frequently asked questions

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

01What is the difference between CPT 24343 and 24344?

24343 is repair using only local tissue. 24344 is reconstruction with a tendon graft. If your surgeon harvested a graft, bill 24344. If the native ligament was repaired in place without a graft, bill 24343. The operative note must support whichever code you choose.

02Is graft harvesting separately billable with 24344?

No. Graft harvest is explicitly included in 24344. Billing a separate harvest code alongside 24344 will trigger a bundling edit and denial.

03Can 24344 be billed for a 'Tommy John' type surgery on the lateral side?

Tommy John specifically refers to ulnar collateral ligament (UCL/MCL) reconstruction — that maps to 24346, not 24344. CPT 24344 is lateral only (LCL/RCL). Verify the operative side before coding.

04Which modifiers apply when 24344 is performed with another elbow procedure on the same day?

Use modifier 51 on the secondary procedure if both are performed in the same session. If NCCI bundles the secondary code, modifier 59 (or an X-modifier if payer accepts it) may be needed with documentation supporting a distinct procedural service.

05How do I bill an E&M visit that occurs within the 90-day global period?

Unrelated E&M visits within the global need modifier 24. A significant, separately identifiable E&M on the day of surgery needs modifier 25. Without the correct modifier, the claim will be denied as bundled into the global.

06Can two surgeons use modifier 62 (co-surgeons) for 24344?

CMS allows modifier 62 on codes where co-surgeon billing is supported, but confirm the specific payer and ASC policies — some payers restrict modifier 62 in the ASC setting. Both surgeons must document their distinct intraoperative roles.

07What ICD-10 diagnosis codes typically pair with 24344?

Lateral collateral ligament injury codes fall under S53.2--- (traumatic) and S53.43-- (sprain of lateral collateral ligament). Chronic instability without a discrete injury event may be coded from the M24.22-- range. Confirm laterality on all codes.

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 graft type, harvest site, ligament abbreviation (LCL/RCL), and the clinical rationale explaining why local tissue repair was not sufficient — the three elements auditors check first on 24344 claims. Locking those details into the operative note at dictation prevents downcoding to 24343 and stops medical necessity denials before they start.

See how Mira captures CPT 24344 documentation