CPT 24102Surgery

Arthrt elbow w/synovectomy

CPT code 24102 describes a surgical procedure where the surgeon opens the elbow joint and removes inflamed synovial tissue (synovectomy). This is typically performed to treat chronic inflammation conditions like rheumatoid arthritis or synovitis that haven't responded to conservative treatment.

Showing rates for

National Average

Base Medicare rate

$614.58

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

8.26

PE RVU (NF)

9.15

MP RVU

1.59

Total RVU

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always append laterality modifier (LT or RT) to CPT 24102 on every claim submission
Impact: Prevents automatic rejection; Medicare requires laterality for all paired procedures or claims are rejected within 24-48 hours
Document extent of synovectomy in operative note, including percentage of synovium removed and specific anatomical compartments addressed
Impact: Supports medical necessity and prevents downcoding to simple arthrotomy (24000) which pays approximately $300 less
Bill 24102 only when synovectomy is primary procedure; if synovectomy is incidental to another major reconstruction, it may be bundled
Impact: Prevents unbundling denials worth $614.58; review NCCI edits quarterly as bundling rules change
For rheumatoid arthritis patients, ensure diagnosis code clearly supports medical necessity (M05.x or M06.x series)
Impact: Vague diagnosis codes (M25.521 pain in right elbow) generate 30-40% higher denial rates than specific inflammatory codes
Verify global period (90 days) and avoid billing related E/M services without modifier 24 during postoperative period
Impact: Unbundled E/M visits during global period result in denials; proper modifier 24 usage can recover $100-200 per visit for unrelated services
When performed with radial head excision or other reconstructive procedures, sequence 24102 as secondary and verify NCCI compatibility
Impact: Incorrect sequencing can reduce payment by 50% when multiple procedure reduction applies; proper sequencing maximizes reimbursement

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Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT code 24102?

The 2025 Medicare national average reimbursement for CPT 24102 is $614.58 for both facility and non-facility settings. This is based on 19.0 total RVUs (8.26 work RVU, 9.15 PE RVU, 1.59 MP RVU) multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by locality based on geographic practice cost indices (GPCI).

What is the difference between CPT 24102 and 24000?

CPT 24102 (arthrotomy with synovectomy) includes removal of diseased synovial tissue from the elbow joint, while CPT 24000 describes simple arthrotomy without synovectomy. The key distinction is whether significant synovial membrane excision is performed. CPT 24102 reimburses approximately $300 more and requires documentation of the extent and therapeutic purpose of synovectomy, not just incidental debridement.

Can CPT 24102 be billed bilaterally with modifier 50?

Yes, CPT 24102 can be billed with modifier 50 when bilateral elbow synovectomy is performed during the same operative session. Medicare typically reimburses bilateral procedures at 150% of the single-side rate (approximately $921.87 total). However, verify individual payer policies as some require two line items with LT/RT modifiers instead of a single line with modifier 50.

What diagnosis codes support medical necessity for CPT 24102?

Primary diagnosis codes supporting CPT 24102 include rheumatoid arthritis (M05.x2 for elbow involvement), other inflammatory polyarthropathies (M06.x2), pigmented villonodular synovitis (M12.22), chronic synovitis (M65.x2), and hemophilic arthropathy (M36.2). The diagnosis must demonstrate chronic inflammatory or proliferative synovial disease requiring surgical intervention. Traumatic arthritis or simple degenerative changes typically receive higher scrutiny.

How many RVUs is CPT code 24102 worth in 2025?

CPT 24102 has a total RVU value of 19.0 in 2025, consisting of 8.26 work RVUs, 9.15 practice expense RVUs (both facility and non-facility), and 1.59 malpractice RVUs. This relatively high RVU value reflects the surgical complexity and time required for open elbow arthrotomy with synovectomy.

What modifiers are required when billing CPT 24102?

Laterality modifiers (LT for left or RT for right) are mandatory for CPT 24102 on all claims. Additional modifiers may include 50 (bilateral), 22 (increased procedural services), 80 (assistant surgeon), 78 (return to OR), or 59 (distinct procedural service) depending on specific circumstances. Missing the laterality modifier will result in automatic claim rejection by most payers including Medicare.

Does CPT 24102 have a global period?

Yes, CPT 24102 has a 90-day global surgical period. This means all routine postoperative care within 90 days of surgery is included in the $614.58 reimbursement. E/M services during this period require modifier 24 (unrelated service) or 25 (significant, separately identifiable service on same day as surgery) to receive separate payment. Complications requiring return to OR use modifier 78.