CPT 24110Surgery

Exc/curtg b1 cst/b9 tum hum

CPT code 24110 covers the surgical removal or scraping out of a bone cyst or benign (non-cancerous) tumor from the humerus, which is the upper arm bone between the shoulder and elbow.

Showing rates for

National Average

Base Medicare rate

$590.32

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

7.58

PE RVU (NF)

9.11

MP RVU

1.56

Total RVU

18.25

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

NCCI bundling edits

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Billing tips

Document the exact anatomical location on the humerus (proximal, mid-shaft, distal) and lesion size in three dimensions (cm). This prevents downcoding to simpler lesion removal codes.
Impact: Prevents potential downcoding to codes like 23184 (soft tissue tumor) which reimburses significantly less, protecting $200-300 in revenue per case
If bone grafting is performed to fill the defect, separately bill for autograft harvesting (20900-20902) or allograft (20930) as these are not bundled with 24110.
Impact: Additional $150-400 reimbursement depending on graft type and volume; autograft harvesting adds 3-6 RVUs
Ensure pathology confirmation is ordered and documented. The pathology report confirming benign nature of the lesion supports medical necessity and protects against audits.
Impact: Critical for audit defense; lack of pathology confirmation is a common reason for post-payment recoupment of full $590.32
Use modifier 22 when lesion size exceeds 5 cm or requires extended dissection near neurovascular structures (radial nerve). Include comparative statement in operative note.
Impact: Can increase reimbursement by $118-295 (20-50%) when supported by documentation showing significantly increased complexity
Verify the lesion is confirmed as benign preoperatively or intraoperatively. If malignancy is suspected or confirmed, codes 23220-23222 (radical resection) are more appropriate and reimburse higher.
Impact: Using correct code for malignant lesions can increase reimbursement to $800-1200; using 24110 for malignant lesion risks denial and compliance issues
Bill facility and non-facility rates correctly based on place of service. ASC and hospital outpatient settings use facility rate ($590.32), while office-based procedures are extremely rare for this code.

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Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT code 24110?

The 2025 Medicare national average reimbursement for CPT 24110 is $590.32 for both facility and non-facility settings. This rate is based on 18.25 total RVUs (7.58 work RVU, 9.11 practice expense RVU, and 1.56 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

Can I bill bone grafting separately with CPT 24110?

Yes, bone grafting codes are separately billable with 24110. Autograft harvesting (20900-20902) and allograft application (20930) are not bundled with 24110 per NCCI edits. Document the graft source, volume, and technique separately in the operative report to support additional reimbursement of $150-400.

What modifiers are most commonly used with CPT 24110?

The most common modifiers for 24110 are RT/LT (laterality), modifier 22 (increased procedural services for large or complex lesions), modifier 51 (multiple procedures), and modifier 59 (distinct procedural service). Laterality modifiers are required for claim processing, while modifier 22 can increase reimbursement by 20-50% when properly documented.

What documentation is required to prevent denials for CPT 24110?

Essential documentation includes preoperative imaging showing the bone lesion, exact anatomical location and three-dimensional size measurements, detailed operative technique describing curettage or excision, pathology specimen submission, and final pathology report confirming benign diagnosis. Missing pathology confirmation is the most common cause of denials and post-payment recoupments.

How does CPT 24110 differ from codes for malignant bone tumors?

CPT 24110 is specifically for benign bone cysts and tumors requiring excision or curettage. Malignant or aggressive bone tumors requiring radical resection are coded with 23220-23222, which involve more extensive bone removal, wider margins, and typically higher reimbursement. Pathology confirmation determines the appropriate code selection.

What are the most common reasons for CPT 24110 claim denials?

The most common denials for 24110 include insufficient documentation of medical necessity (lesion size/characteristics not described), lack of pathology confirmation of benign diagnosis, incorrect bundling with bone grafting procedures, and incorrect code selection when soft tissue tumor codes would be more appropriate. Each can be successfully appealed with proper documentation.

What is the global period for CPT 24110?

CPT 24110 has a 90-day global period. All routine postoperative care related to the bone cyst/tumor excision is included in the $590.32 reimbursement. Complications requiring return to the operating room should be coded with modifier 78, while unrelated procedures during the global period require modifier 79.