Closed treatment of a simple elbow dislocation performed without anesthesia, involving manual reduction and stabilization of the joint.

Verified May 8, 2026 · 5 sources ↓

Medicare: $476.63
Total RVUs: 14.27
Global, days: 90
Region: Elbow

Drawn from CMSAAOSAAPC

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Explicit statement that no anesthesia (local, regional, or general) was used during the reduction
Description of the type of dislocation and direction of displacement (posterior, anterior, lateral, medial)
Confirmation that no fracture was present — imaging results or radiograph interpretation supporting simple dislocation
Post-reduction neurovascular status documentation (pulses, sensation, motor function)
Immobilization method applied (splint, cast, sling) and position of elbow at time of immobilization
Pre- and post-reduction clinical findings supporting successful closed reduction

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 52 Reduced services 57 Decision for surgery 58 Staged or related 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

24600 covers closed reduction of an elbow dislocation where no anesthesia — local, regional, or general — is administered. The physician manipulates the joint back into anatomic alignment and confirms reduction, typically followed by immobilization. This code applies to simple (uncomplicated) dislocations; if anesthesia is required, step up to 24605.

The 90-day global period means post-reduction office visits, repeat neurovascular checks, and routine splint or cast management are all bundled. Any E/M service on the day of reduction that reflects the decision to perform the procedure is included in the global package — modifier 57 does not apply here because 57 is reserved for major procedures where the decision visit is the day before or day of surgery. Use modifier 25 if a separate, significant E/M was performed on the same date for a genuinely distinct problem.

Site-of-service matters for this code. The HOPD and ASC payment rates differ substantially; bill the correct place-of-service code to avoid automatic downcoding. Confirm the dislocation is simple — involvement of a fracture (e.g., radial head, coronoid) changes the coding entirely and likely warrants a different CPT. Document the absence of anesthesia explicitly; payers flag 24600 claims when operative or procedure notes are silent on this point.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	4.26
Practice expense RVU	8.99
Malpractice RVU	1.02
Total RVU	14.27
Medicare national rate	$476.63
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	$476.63
HOPD (APC 5111) Hospital outpatient department	$252.01
ASC (PI A2) Ambulatory surgical center (freestanding)	$135.54

Common denial reasons

The recurring reasons claims for CPT 24600 get rejected.

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

Anesthesia documented in the record triggers a mismatch — payer expects 24605 when any anesthesia is noted
Concurrent fracture coding (e.g., radial head) without appropriate modifier to clarify separate procedures
Missing or vague post-reduction documentation fails to support medical necessity for the global follow-up visits billed during the 90-day period
Incorrect place-of-service code causing payment at wrong site-of-service rate or triggering a technical denial
Unbundling of a same-day E/M without modifier 25 when the visit was part of the routine pre-reduction assessment

Frequently asked questions

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

01What's the difference between 24600 and 24605?

24600 is closed reduction without anesthesia. 24605 is the same procedure performed with anesthesia. If you gave any anesthesia — even a local nerve block for procedural comfort — use 24605. Payers audit this distinction closely, and a procedure note that mentions sedation or a nerve block on a 24600 claim is a fast path to denial or recoupment.

02Can I bill a separate E/M on the same day as the reduction?

Only if the E/M was for a genuinely distinct problem unrelated to the elbow dislocation. Append modifier 25 to the E/M and document the separate medical decision-making. The routine pre-reduction assessment is bundled into 24600 and cannot be billed separately.

03Does the 90-day global cover all follow-up visits?

Yes. Routine post-reduction visits, cast or splint checks, and removal of immobilization within 90 days are all bundled. If a new, unrelated condition is treated during that window, bill the E/M with modifier 24. If a complication requires a return procedure, use modifier 78 (related, unplanned) or 79 (unrelated) depending on the clinical situation.

04What if there's also a radial head fracture?

A concurrent fracture makes this a fracture-dislocation, which changes the coding. 24600 describes a simple dislocation without fracture. Report the appropriate fracture code separately and append modifier 59 or the relevant X modifier if NCCI edits apply. Confirm the clinical and imaging documentation clearly supports both injuries.

05Is 24600 appropriate for pediatric nursemaid's elbow (radial head subluxation)?

No. Nursemaid's elbow (annular ligament displacement) is coded with 24640, not 24600. The AAPC community has flagged this confusion repeatedly. 24600 is for true elbow dislocation. Using 24600 for a nursemaid's elbow is an overcoding risk.

06How does site of service affect reimbursement?

HOPD and ASC payment rates for 24600 differ — see the site-of-service comparison table on this page. Bill the place-of-service code that matches where the procedure was actually performed. A mismatch between the POS code and the billed setting is a common technical denial trigger.

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 absence of anesthesia, dislocation direction, pre- and post-reduction neurovascular exam, imaging findings confirming no associated fracture, and the immobilization technique applied — the exact elements auditors check first on 24600 claims. That prevents the two most common denials: upcoding to 24605 when anesthesia is undocumented, and downcoding when post-reduction status is missing.

See how Mira captures CPT 24600 documentation