Fracture care · Elbow

24615

Open treatment of acute or chronic elbow dislocation, with or without internal or external fixation

Verified May 8, 2026 · 5 sources ↓

Medicare
$664.68
Total RVUs
19.9
Global, days
90
Region
Elbow
Drawn from CMSAAPCFindacode

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

  • Specify acuity: document whether the dislocation is acute or chronic, including chronicity timeline if relevant
  • Describe the surgical approach by name (lateral, medial, posterior, combined) — notes that say 'standard approach' draw audit scrutiny
  • Record intraoperative findings including direction of dislocation, capsular/ligamentous integrity, and presence of associated fractures
  • Document all stabilization methods used: suture anchors, ligament repair technique, external fixation device, K-wire placement
  • Include pre- and post-reduction fluoroscopic or radiographic confirmation of joint congruence in the operative note
  • If billing with additional codes (e.g., coronoid ORIF, radial head replacement), document each as a distinct surgical step with separate indication

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 24615 covers open surgical treatment of an elbow dislocation — acute or chronic — where the surgeon directly accesses the joint to achieve reduction and stabilization. This is a distinctly different code from closed treatment (24600, 24605); 24615 applies when open exposure is required, whether due to irreducibility, associated ligamentous instability demanding surgical repair, or a chronic dislocation that cannot be managed closed.

The 90-day global period means all routine post-op management, splint changes, and follow-up visits through day 90 are bundled. Bill an E/M in that window only if it addresses a problem unrelated to the elbow dislocation — and attach modifier 24. If a separate, distinct procedure is performed during the global for an unrelated condition, use modifier 79. A return to the OR for a complication directly related to the original dislocation repair uses modifier 78.

When the procedure involves significantly greater complexity — for example, addressing a Terrible Triad injury pattern with concurrent coronoid fixation or lateral ligament reconstruction billed under separate codes — document the additional work thoroughly if modifier 22 is appended. Payers will require the operative note to justify any upward complexity claim.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU9.58
Practice expense RVU8.36
Malpractice RVU1.96
Total RVU19.9
Medicare national rate$664.68
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
$664.68
HOPD (APC 5114)
Hospital outpatient department
$7,413.38
ASC (PI J8)
Ambulatory surgical center (freestanding)
$5,397.52

Common denial reasons

The recurring reasons claims for CPT 24615 get rejected.

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

  • Upcoding concern when closed treatment (24605) would have sufficed — lack of documentation justifying open approach
  • Bundling denials when concurrent fracture fixation codes are billed without modifier 59 or XS establishing distinct procedural identity
  • Global period violations: routine post-op E/M billed without modifier 24 during the 90-day window
  • Missing or vague operative note — 'elbow dislocation reduced and stabilized' without approach, findings, or fixation detail
  • Bilateral modifier 50 applied incorrectly when only one elbow was operated on, or LT/RT omitted when payer requires laterality

Frequently asked questions

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

01What separates 24615 from 24605?
24605 is open treatment of an acute dislocation — the most common scenario. 24615 specifically covers acute or chronic dislocations treated open, and is the appropriate code when chronicity is the clinical driver or when the operative complexity reflects a long-standing unreduced joint. Use 24600 for closed treatment without anesthesia, 24605 for closed with anesthesia or open acute. If the chart documents a chronic or recurrent dislocation requiring open reconstruction, 24615 is correct.
02Can I bill 24615 with coronoid ORIF or radial head replacement on the same day?
Yes, but each additional code needs modifier 59 or XS to identify it as a distinct procedural service. AAPC forum guidance confirms 24615 does not automatically hit an NCCI bundle edit with coronoid fixation codes, but payers vary. Document each procedure as a separate surgical step with its own indication in the operative note.
03How does the 90-day global period affect post-op billing?
All routine elbow follow-up, dressing changes, splint management, and suture removal through day 90 are bundled. An E/M for an unrelated problem (e.g., hypertension management) needs modifier 24. A new injury to a different body part uses modifier 79. A return to the OR for a complication related to the elbow repair uses modifier 78.
04When is modifier 22 justified for 24615?
Modifier 22 is defensible when documented intraoperative complexity materially exceeds what a typical elbow dislocation repair requires — for example, a Terrible Triad pattern with multi-ligament reconstruction performed through the same session. The operative note must quantify increased time, difficulty, or risk. Payers frequently request supporting documentation before paying the upcharge.
05Does site of service affect reimbursement for 24615?
Yes. HOPD and ASC facility payments differ significantly — see the Site of Service comparison table on this page. The physician's professional fee also adjusts by site: the practice expense RVU component is lower when the procedure is performed in a facility setting (HOPD or ASC) versus a non-facility (office) setting.
06Is modifier 50 ever appropriate for 24615?
Bilateral elbow dislocation is rare but not impossible — bilateral modifier 50 applies if both elbows are treated open in the same session. More commonly, LT or RT is appended when a payer requires laterality designation on unilateral procedures. Always check individual payer requirements; Medicare does not universally require LT/RT on elbow codes but many commercial payers do.

Sources & references

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

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    aapc.com
    https://www.aapc.com/codes/cpt-codes/24615
  3. 03
    findacode.com
    https://www.findacode.com/cpt/24615-cpt-code.html
  4. 04
    cms.gov
    https://www.cms.gov/files/document/r13033cp.pdf
  5. 05
    cms.gov
    https://www.cms.gov/files/document/r13575cp.pdf

Mira AI Scribe

Mira's AI scribe captures the dislocation acuity (acute vs. chronic), surgical approach by name, intraoperative findings (capsular tears, ligament integrity, associated fractures), and all fixation constructs used. That specificity prevents the most common denial for 24615: an operative note too vague to distinguish open treatment from a closed reduction attempt, which triggers downcoding to 24605.

See how Mira captures CPT 24615 documentation

Related CPT codes

Ready?

Ready to transform your orthopedic practice?

See how orthopedic practices are running documentation, billing, and operations on a single voice-first platform.

Get started for free