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
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 RVU | 9.58 |
| Practice expense RVU | 8.36 |
| Malpractice RVU | 1.96 |
| Total RVU | 19.9 |
| Medicare national rate | $664.68 |
| 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 | $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?
02Can I bill 24615 with coronoid ORIF or radial head replacement on the same day?
03How does the 90-day global period affect post-op billing?
04When is modifier 22 justified for 24615?
05Does site of service affect reimbursement for 24615?
06Is modifier 50 ever appropriate for 24615?
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 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