CPT 24105Surgery

Excision olecranon bursa

CPT code 24105 covers the surgical removal of the olecranon bursa, a fluid-filled sac at the tip of the elbow that can become inflamed or infected. This procedure is performed when conservative treatments fail to resolve chronic bursitis or infection.

Showing rates for

National Average

Base Medicare rate

$363.25

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

3.78

PE RVU (NF)

6.71

MP RVU

0.74

Total RVU

11.23

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

NCCI bundling edits

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Billing tips

Document medical necessity clearly by detailing failed conservative treatments (minimum 4-6 weeks of conservative care including rest, NSAIDs, aspiration attempts, or steroid injections)
Impact: Prevents medical necessity denials which account for 35-40% of rejections for this code; can save the full $363.25 reimbursement
Ensure operative report specifies complete excision of the bursal sac, not just drainage or debridement, and documents pathology submission
Impact: Differentiates from aspiration (20605/20606) or incision and drainage (23930); prevents downcoding that would reduce payment by $150-200
Bill in non-facility setting when performed in office-based surgical suite to capture higher facility overhead
Impact: Both facility and non-facility rates are $363.25 for 24105, but verify PE RVU recognition for practice expense costs
Do not separately bill for bursal fluid culture or pathology interpretation as these are included in the surgical package
Impact: Prevents unbundling denials and potential fraud audits; saves compliance risk worth thousands in potential audit recovery
When performed with other elbow procedures, verify NCCI edits and use modifier 59/XU only when anatomically distinct or separate surgical site
Impact: Improper modifier usage results in bundling; correct usage can preserve $300+ for appropriately separate procedures
For Medicare patients, verify the procedure meets LCD (Local Coverage Determination) criteria including documentation of recurrent symptoms after conservative therapy
LCD compliance prevents denials in specific MAC jurisdictions; failure to meet criteria results in full claim denial of $363.25

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 24105 in 2025?

The 2025 Medicare national average payment for CPT 24105 is $363.25 for both facility and non-facility settings. This is based on 11.23 total RVUs (3.78 work RVU, 6.71 PE RVU, 0.74 MP RVU) multiplied by the 2025 conversion factor of 32.3465. Geographic adjustments may affect actual payment in your locality.

What is the difference between CPT 24105 and bursa aspiration codes?

CPT 24105 is for complete surgical excision (removal) of the olecranon bursa through an incision, requiring dissection and closure. Aspiration codes (20605/20606) involve only needle drainage of fluid without removing the bursal sac. Excision is definitive treatment requiring an operative setting, while aspiration is a diagnostic or temporary therapeutic office procedure.

How much conservative treatment is required before billing CPT 24105?

Most payers require documentation of at least 4-6 weeks of failed conservative treatment before approving surgical excision. This typically includes rest, activity modification, NSAIDs, compression, and at least one attempt at aspiration with or without corticosteroid injection. Acute septic bursitis not responding to antibiotics and aspiration may justify earlier surgical intervention.

Can CPT 24105 be billed bilaterally with modifier 50?

Yes, if bilateral olecranon bursa excision is performed during the same operative session, modifier 50 can be used. Medicare typically reimburses bilateral procedures at 150% of the unilateral rate ($544.88 total). However, some payers require two separate line items with LT and RT modifiers instead of modifier 50, so verify payer-specific billing guidelines.

What documentation is needed to support medical necessity for CPT 24105?

Required documentation includes detailed history of chronic symptoms, physical exam findings showing persistent bursal swelling, imaging confirming bursal pathology, comprehensive record of all conservative treatments attempted with dates and outcomes, and clinical justification for why surgery is necessary. Operative report must describe complete excision of the bursal sac with pathology submission.

What is the global period for CPT 24105?

CPT 24105 has a 90-day global surgical period. This means all routine postoperative care for 90 days after surgery is included in the $363.25 payment and cannot be billed separately. Complications, unrelated conditions, or return to OR during this period require appropriate modifiers (24, 78, 79) for separate reimbursement.

Can CPT 24105 be performed in an office setting?

Yes, CPT 24105 can be performed in an office-based surgical suite equipped for sterile surgical procedures. Both facility and non-facility Medicare rates are $363.25 in 2025. When performed in an office setting, ensure proper documentation of sterile technique, anesthesia administration, and availability of appropriate monitoring and emergency equipment to support the surgical nature of the procedure.