Joint replacement · Elbow

24362

Elbow arthroplasty using a distal humeral implant combined with fascia lata graft harvest and ligament reconstruction to restore joint stability.

Verified May 8, 2026 · 5 sources ↓

Medicare
$975.97
Total RVUs
29.22
Global, days
90
Region
Elbow
Drawn from CMSCgsmedicareFastrvuFindacode

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

  • Operative note must identify the specific implant placed at the distal humerus, including manufacturer and component size
  • Document the fascia lata graft harvest site (thigh) and graft dimensions used for ligament reconstruction
  • Describe the joint capsule reconstruction technique by name — do not use 'standard approach' or 'routine reconstruction'
  • Specify the surgical approach to the elbow (lateral, medial, posterior, combined) with anatomical landmarks
  • Preoperative diagnosis with supporting imaging must correlate to the reconstructive procedure performed
  • If concurrent nerve procedure performed, document nerve condition, technique, and medical necessity separately

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 24362 covers reconstruction of the elbow joint using a prosthetic implant fitted to the distal humerus combined with a fascia lata ligament reconstruction. The fascia lata graft is harvested from the thigh and used to rebuild the joint capsule and ligamentous support around the implant — distinguishing this code from 24361 (distal humeral prosthetic replacement alone) and 24363 (total elbow with proximal ulnar component). Use 24362 when the operative note documents both the humeral prosthesis and the fascia lata harvest and reconstruction; if only the humeral prosthesis is placed without ligament reconstruction, 24361 applies.

The 90-day global period covers the day before surgery, the surgical day, and all routine post-op management through day 90. Separate E/M visits during that window require modifier 24 (unrelated) or 25 (significant, separately identifiable, same-day pre-op). New problems, fractures, or contralateral elbow issues arising in the global period are billable with modifier 79.

NCCI bundles several elbow procedures as components of arthroplasty. Arthrocentesis of the same joint on the same date is not separately reportable. Ulnar nerve transposition (64718) is separately reportable with modifier 59 or XU when performed alongside elbow tendon work, per CMS NCCI Chapter 4 guidance — verify the same logic applies to your arthroplasty-adjacent scenario against the current PTP edit table before billing.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU14.94
Practice expense RVU11.1
Malpractice RVU3.18
Total RVU29.22
Medicare national rate$975.97
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
$975.97
HOPD (APC 5115)
Hospital outpatient department
$13,116.76
ASC (PI J8)
Ambulatory surgical center (freestanding)
$9,667.45

Common denial reasons

The recurring reasons claims for CPT 24362 get rejected.

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

  • Wrong code selection — 24361 used when fascia lata reconstruction was also performed, or 24363 used when the ulnar component was not implanted
  • Missing documentation of fascia lata graft harvest; payers audit for evidence of the ligament reconstruction component that distinguishes 24362 from adjacent codes
  • Unbundling denial when arthrocentesis of the same elbow joint is billed separately on the same date of service
  • Global period violation — E/M services billed without modifier 24 or 25 during the 90-day post-op window
  • ICD-10 diagnosis mismatch — degenerative or traumatic diagnosis not clearly supporting the need for implant plus ligament reconstruction

Frequently asked questions

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

01What separates 24362 from 24361 and 24363?
24361 is distal humeral prosthetic replacement only. 24362 adds fascia lata ligament reconstruction around that implant. 24363 goes further — it includes both distal humerus and proximal ulnar components (total elbow). The fascia lata harvest and ligament reconstruction must be documented in the operative note to support 24362 over 24361.
02Can I bill 24362 and 24363 together if the procedure evolves intraoperatively?
No. These codes are mutually exclusive — 24363 describes total elbow replacement with both humeral and ulnar components. If the ulnar component is placed, 24363 is the correct code regardless of whether fascia lata work was also performed. Billing both on the same date will trigger an NCCI edit denial.
03Is ulnar nerve transposition separately billable with 24362?
CMS NCCI Chapter 4 addresses ulnar nerve transposition (64718) as separately reportable when performed with elbow tendon procedures using modifier 59 or XU. Verify the current PTP edit status for the 24362/64718 pair using the CMS NCCI PTP lookup tool before billing, and ensure the operative note documents distinct medical necessity for the nerve procedure.
04What modifiers apply when billing 24362 during another surgeon's global period?
Use modifier 79 if the elbow reconstruction is unrelated to the original procedure that opened the global period. Use modifier 78 only if you are returning to the OR for a complication directly related to the prior surgery. Inverting 78 and 79 is a common audit finding.
05Does modifier 22 apply to 24362, and what documentation supports it?
Modifier 22 applies when the work substantially exceeds the typical procedure — for example, significant scar tissue from prior surgeries, complex deformity, or failed prior implant requiring extensive reconstruction. The operative note must describe the specific factors that increased time and complexity, and a cover letter to the payer explaining the increased work is standard practice.
06Can 24362 be billed same-day with a fascia lata harvest code?
No. The fascia lata graft harvest is integral to 24362 — it is the source material for the ligament reconstruction component of the procedure. Billing a separate graft harvest code on the same date would trigger an NCCI bundling denial.

Mira AI Scribe

Mira's AI scribe captures the distal humeral implant details (type, manufacturer, size), fascia lata harvest site and graft dimensions, the ligament reconstruction technique, and the named surgical approach to the elbow from the surgeon's dictation. This prevents the single most common audit flag for 24362: operative notes that document a prosthesis without explicitly describing the fascia lata harvest and reconstruction, which reviewers use to downcode to 24361.

See how Mira captures CPT 24362 documentation

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