Soft tissue repair · Elbow

24357

Percutaneous repair of the elbow tendon, performed through a minimally invasive approach without a large open incision.

Verified May 8, 2026 · 5 sources ↓

Medicare
$384.44
Total RVUs
11.51
Global, days
90
Region
Elbow
Drawn from CMSMdclarityAAPCPayerpriceAAOS

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 approach explicitly as percutaneous — notes stating only 'minimally invasive' without further detail are audit flags.
  • Document the specific tendon or structure repaired (e.g., common extensor tendon at lateral epicondyle) and the side (left or right).
  • Include failed conservative treatment history: duration of symptoms, prior physical therapy, injections, or bracing tried before surgery.
  • Operative note must describe needle or instrument entry site(s), technique used (e.g., tenotomy, ultrasonic debridement), and intraoperative findings.
  • If ultrasound guidance was used, document real-time image guidance with permanent record of images and separate interpretation note if billing 76882-26.
  • Pre-op diagnosis and post-op diagnosis must align with the ICD-10 code submitted — lateral epicondylitis (M77.1x) is the most common pairing.

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 5 cited references ↓

CPT 24357 describes a percutaneous elbow repair — most commonly applied to lateral epicondyle pathology (tennis elbow) when the surgeon addresses the tendon through a needle-based or small-puncture technique rather than open exposure. The 90-day global period covers all routine post-op management from the day before surgery through day 90. Anything unrelated billed in that window needs modifier 24 (E/M) or 79 (unrelated procedure); a staged or planned related procedure gets modifier 58.

The code is most frequently billed by hand surgeons and, notably, family practice physicians — the latter often performing office-based Tenex-style ultrasonic debridement procedures coded under 24357. When ultrasound guidance is used intraoperatively, some practices append 76882-26 for the imaging component; confirm payer bundling rules before appending, as not all commercial payers allow separate payment.

Site of service matters here. The gap between HOPD and ASC facility payments is significant — see the Site of Service comparison table. Performing this procedure in an ASC rather than an HOPD setting affects the facility fee but not the physician's professional fee, which is set by the CMS Physician Fee Schedule 2026.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU5.3
Practice expense RVU5.59
Malpractice RVU0.62
Total RVU11.51
Medicare national rate$384.44
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
$384.44
HOPD (APC 5113)
Hospital outpatient department
$3,342.87
ASC (PI G2)
Ambulatory surgical center (freestanding)
$1,644.87

Common denial reasons

The recurring reasons claims for CPT 24357 get rejected.

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

  • Missing or inadequate documentation of failed conservative treatment, which most payers require before approving elbow tendon repair.
  • Operative note describes an open approach or debridement inconsistent with percutaneous technique, triggering a code mismatch denial.
  • Laterality modifier (LT or RT) absent, causing claim rejection or processing delay on payers that require it for upper extremity codes.
  • Ultrasound guidance (76882-26) billed separately when the payer bundles it into 24357 — check payer-specific NCCI edits before appending.
  • Global period violation: post-op E/M billed without modifier 24, or a related procedure billed without modifier 78, during the 90-day window.

Frequently asked questions

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

01Is 24357 the right code for a Tenex (ultrasonic tenotomy) procedure on the lateral epicondyle?
Yes. Many upper extremity specialists and coders use 24357 for Tenex-style percutaneous tenotomy at the lateral epicondyle. If ultrasound guidance was performed and documented separately, some practices also append 76882-26, but confirm your payer's bundling policy first — not all allow separate imaging payment.
02What ICD-10 codes most commonly pair with 24357?
Lateral epicondylitis (M77.11 right, M77.12 left) is the dominant pairing. Medial epicondylitis (M77.01/M77.02) and other tendon disorders at the elbow (M66.321/M66.322) also map appropriately depending on the operative findings documented.
03Does the 90-day global period affect how I bill a post-op injection or E/M visit?
Yes. Routine post-op E/M visits are bundled into the global. If you need to bill an unrelated E/M during the 90-day window, append modifier 24 and document a diagnosis clearly unrelated to the original procedure. An unrelated surgical procedure in the global period requires modifier 79.
04Can 24357 be billed bilaterally in the same session?
Yes. Append modifier 50 for a bilateral procedure performed in the same session, or use LT and RT on separate line items depending on the payer's billing preference. Check your MAC's instructions — some require modifier 50 on a single line, others want two lines.
05What is the difference between 24357, 24358, and 24359?
24357 is the percutaneous-only repair. 24358 adds open debridement of soft tissue and/or bone. 24359 further includes a tendon or ligament repair component in an open approach. Select the code that matches the documented surgical technique — upcoding from 24357 to 24359 without operative findings supporting the additional work is an audit risk.
06Do I need prior authorization for 24357?
Most commercial payers require prior authorization for elbow tendon repair and will also want documentation of conservative treatment failure (typically 3–6 months of physical therapy, NSAIDs, or injections). Medicare does not require prior auth, but LCD policies from your MAC may define coverage criteria — check your regional MAC's LCD for musculoskeletal procedures.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    mdclarity.com
    https://www.mdclarity.com/cpt-code/24357
  3. 03
    aapc.com
    https://www.aapc.com/codes/cpt-codes/24357
  4. 04
    payerprice.com
    https://payerprice.com/rates/24357-CPT-fee-schedule
  5. 05
    aaos.org
    https://www.aaos.org/quality/coding-and-reimbursement/

Mira AI Scribe

Mira's AI scribe captures the percutaneous approach, specific tendon and anatomic location treated, laterality, intraoperative findings, and whether ultrasound guidance was used — pulling these directly from dictation and populating the operative note fields that CMS and commercial payers audit first. That prevents the two most common denials: approach-mismatch (open vs. percutaneous) and missing laterality, both of which trigger manual review or outright rejection.

See how Mira captures CPT 24357 documentation

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