Forearm decompression fasciotomy performed with concurrent brachial artery exploration to relieve compartment pressure and assess vascular integrity.

Verified May 8, 2026 · 6 sources ↓

Medicare: $906.50
Total RVUs: 27.14
Global, days: 90
Region: Elbow

Drawn from CMSAAPCEatonhandAbosWorkerscomp

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Operative note must explicitly state brachial artery exploration was performed, not simply that the exposure included proximity to the vessel.
Document the specific compartment(s) decompressed — flexor, extensor, or both — even though the compartment distinction doesn't change the code here.
Record pre- and intraoperative compartment pressure measurements (mm Hg) when available, particularly if the diagnosis of acute compartment syndrome is not clinically obvious.
Note whether necrotic muscle or nerve tissue was debrided; while debridement doesn't alter this code, the presence or absence affects ICD-10 specificity and supports medical necessity.
Document the surgical approach — volar, dorsal, or combined incision(s) — by name and length to defend against audit flags for inadequate operative notes.
Include the indication: acute compartment syndrome, vascular injury, trauma mechanism, or post-operative swelling, as the ICD-10 pairing drives medical necessity review.

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 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 24495 describes a forearm fasciotomy with brachial artery exploration — the defining element that separates it from the 25020–25025 family of forearm decompression codes. The surgeon incises the forearm fascia to decompress the compartment, then explores the brachial artery, typically when vascular compromise is suspected as a cause or consequence of compartment syndrome. The brachial artery exploration is not incidental; its absence pushes the case toward 25020/25023 (single compartment) or 25024/25025 (both compartments), depending on whether debridement of nonviable muscle or nerve is performed.

Code selection within the forearm fasciotomy family hinges on two variables: compartment (flexor only, extensor only, or both) and debridement (performed or not). 24495 sits outside that matrix entirely because it adds a distinct anatomic element — brachial artery exploration — rather than varying on debridement. Operative notes must document the artery was explicitly explored, not merely that the incision passed nearby.

The 90-day global period applies. Any complication management, wound care, or secondary closure within that window is bundled unless a separate, unrelated condition is documented and modifier 24 appended. Delayed primary closure or split-thickness skin grafting required after wound left open is reportable separately under modifier 78 if unplanned and related.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.2
Practice expense RVU	17.2
Malpractice RVU	1.74
Total RVU	27.14
Medicare national rate	$906.50
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	$906.50
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 24495 get rejected.

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

Operative note lacks documentation of brachial artery exploration, causing the claim to be downcoded to 25020 or 25024 by the payer.
Code billed without a supporting diagnosis of acute compartment syndrome or documented vascular compromise — payers require a matching ICD-10 to validate medical necessity.
Same-day fasciotomy and a separate wound closure or skin graft billed without modifier 78 or 79, triggering a bundling denial under NCCI edits.
Global period violations: post-operative visit claims within 90 days submitted without modifier 24, incorrectly implying an unrelated E/M when the visit was routine follow-up.
Site-of-service mismatch — HOPD rate claimed when the procedure was performed in an ASC, or vice versa, creating payment discrepancy flags.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What distinguishes 24495 from 25020 or 25024?

24495 requires brachial artery exploration in addition to forearm fasciotomy. The 25020/25023/25024/25025 codes vary by compartment (flexor vs. extensor vs. both) and debridement, but none include arterial exploration. If the artery isn't documented as explored, bill the appropriate 250xx code instead.

02Can 24495 and 25020/25025 be billed on the same day?

Only with very strong operative documentation showing genuinely distinct work. These codes occupy overlapping anatomic territory; payers and NCCI edits will scrutinize same-day billing aggressively. If the fasciotomy and arterial exploration were one continuous procedure, bill 24495 alone.

03Does debridement of nonviable muscle change the code from 24495?

No. Unlike the 25020-series where debridement drives code selection (25023 vs. 25020, 25025 vs. 25024), 24495 has no debridement variant. Document debridement thoroughly for ICD-10 specificity and medical necessity, but it doesn't move you to a different code.

04What modifier applies if delayed wound closure is performed weeks later?

Use modifier 78 if the return to the OR for closure is related to the original fasciotomy — it was left open intentionally, as is standard for compartment syndrome. The 90-day global applies, so without modifier 78 the closure claim will deny as bundled.

05Is 24495 appropriate for both acute traumatic compartment syndrome and post-surgical compartment syndrome?

Yes, provided the brachial artery is explored. The etiology — trauma, supracondylar fracture complication, or post-operative swelling — drives your ICD-10 selection, not the CPT code. Document the underlying mechanism clearly; payers review this pairing for medical necessity.

06How does the 90-day global period affect billing for this procedure?

All routine post-operative care from the day before surgery through day 90 is bundled. Separate E/M visits during that window need modifier 24 to signal an unrelated condition. Unplanned related returns to the OR require modifier 78; unrelated procedures need modifier 79.

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 brachial artery exploration from dictation as a discrete, named element — not just a mention of vascular proximity — and records the compartment(s) decompressed, incision description, intraoperative pressure measurements, and whether debridement was performed. This prevents the single most common denial for 24495: downcoding to the 25020-series because the operative note failed to clearly document arterial exploration.

See how Mira captures CPT 24495 documentation