Revision of total elbow arthroplasty for a single failed component (humeral or ulnar), with allograft bone grafting performed when required.

Verified May 8, 2026 · 7 sources ↓

Medicare: $1,376.79
Total RVUs: 41.22
Global, days: 90
Region: Elbow

Drawn from CMSAAPCNIHFindacodeMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Specify which component is being revised — humeral or ulnar — by name in the operative report header and body
State whether allograft bone graft was used and document the graft source, preparation, and implantation site
Document the reason for revision: loosening, periprosthetic fracture, wear, infection, instability, or other failure mode with supporting imaging or intraoperative findings
Record the implant removed and implant placed, including manufacturer, catalog number, and size
If modifier 22 is appended, include a narrative paragraph quantifying increased operative time and complexity beyond a typical single-component revision
Confirm place of service in the facility record — HOPD vs. ASC determines the applicable facility payment rate

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 51 Multiple procedures 52 Reduced services 58 Staged or related 62 Co-surgeons 74 Discontinued post-anesthesia 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 24370 covers revision surgery on a previously implanted total elbow arthroplasty when one component — either the humeral or ulnar side — has failed, loosened, or requires reconstruction. The surgeon removes the failed component, prepares the bone bed, and reimplants a new component; allograft bone graft is included in the code when used. If both the humeral and ulnar components require revision in the same session, report 24371 instead.

This is a 90-day global procedure. All routine post-op visits, wound checks, and suture removals through day 90 are bundled. Any E/M service for an unrelated problem during the global window requires modifier 24. A staged or planned second procedure within the global period uses modifier 58; an unplanned return to the OR for a related complication uses modifier 78.

Site of service matters significantly here — see the HOPD vs. ASC payment comparison on this page. The HOPD rate exceeds the ASC rate by a meaningful margin, so confirming the correct place-of-service code on the claim is non-negotiable. Modifier 22 is available when operative complexity substantially exceeds the typical revision (e.g., severe bone loss, fracture, or hardware extraction difficulty), but the operative note must quantify the added work and time.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	22.96
Practice expense RVU	13.65
Malpractice RVU	4.61
Total RVU	41.22
Medicare national rate	$1,376.79
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	$1,376.79
HOPD (APC 5115) Hospital outpatient department	$13,116.76
ASC (PI J8) Ambulatory surgical center (freestanding)	$8,621.29

Common denial reasons

The recurring reasons claims for CPT 24370 get rejected.

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

Wrong code selection: both components revised same session without upcoding to 24371, resulting in undercoding or bundling disputes
Missing documentation distinguishing which component was revised — payers audit for humeral vs. ulnar specificity
Allograft use not documented; payers deny the all-inclusive code when operative note omits graft details and they suspect unbundling
Modifier 22 appended without a supporting narrative justifying increased complexity, prompting automatic denial or reduction
Global period violations: E/M billed without modifier 24 during the 90-day window flagged as duplicate or inclusive services

Frequently asked questions

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

01When do I use 24370 vs. 24371?

24370 is for revision of a single component — humeral or ulnar. 24371 covers revision of both components in the same session. Confirm in the operative note which component(s) were explanted and replaced before selecting the code.

02Is allograft bone graft separately billable with 24370?

No. Allograft is included in the code descriptor when performed. Do not bill a separate graft code alongside 24370 — that will trigger an NCCI bundling denial.

03Can I bill 24370 with modifier 50 for bilateral elbow revision?

Bilateral total elbow revision in the same session is extraordinarily rare, but if documented, modifier 50 applies. Most payers will require prior authorization and a detailed operative note confirming both elbows were operated. Use LT and RT as an alternative if the payer requires separate line billing.

04What modifier applies if the patient returns to the OR within the 90-day global for a related complication?

Modifier 78 — unplanned return to the OR for a related procedure during the postoperative period. Do not use modifier 79, which is reserved for unrelated procedures by the same physician during the global window.

05Does modifier 22 require any specific documentation threshold?

Yes. Append a separate paragraph in the operative note stating why the procedure exceeded typical revision complexity — quantify additional operative time, describe bone loss severity, hardware removal difficulty, or other complicating factors. Payers routinely deny modifier 22 on elbow revision claims that lack this narrative.

06How does site of service affect reimbursement for 24370?

HOPD and ASC payment rates differ substantially for this code — see the site-of-service comparison table on this page. Submitting the wrong place-of-service code results in either overpayment exposure or underpayment. Confirm the facility type before claim submission.

07Can a co-surgeon bill 24370 with modifier 62?

Modifier 62 is applicable when two surgeons of different specialties each perform a distinct portion of the procedure and both document their individual contributions. For elbow revision, this is uncommon but defensible if, for example, an orthopedic surgeon and a plastic surgeon each performed separate operative components with distinct dictation.

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 failed component (humeral vs. ulnar), allograft use and graft details, reason for revision with intraoperative findings, and implant data from dictation — automatically flagging notes that omit component laterality or graft documentation. This prevents the most common audit trigger for 24370: operative reports that confirm a revision occurred but don't specify which component, leaving coders unable to defend single-component billing against 24371 scrutiny.

See how Mira captures CPT 24370 documentation