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Billing code 24358: Elbow tenotomyMedicare rate & RVUs

Open elbow surgery for lateral or medial epicondylitis that releases the affected tendon and debrides diseased soft tissue or bone.

CMS RVU26DEffective Oct 1, 2026109 payment localities709 Medicare services in 2024

Medicare pays $500.01 for 24358 nationally in a facility.

Medicare rate · 24358

Elbow tenotomy

Swap in your local Medicare rate.

Work RVUs
6.49
Total RVUs
14.97
Global days
090

National rate · 2026

$500.01

Facility setting, before claim adjustments.

See every locality for 24358 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 24358 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 24358 covers

This operation treats persistent lateral or medial epicondylitis by surgically releasing the involved tendon and removing diseased soft tissue and/or bone. A common example is open treatment of chronic tennis elbow involving the common extensor origin; medial epicondylitis may involve the flexor origin. Orthopedic and hand surgeons typically perform it in an operating room, such as a hospital outpatient department or ambulatory surgery center.

Report 24358 when the surgeon uses an open approach and performs the release with debridement, without the origin detachment and reattachment that distinguishes 24359. The operative report should identify the affected side and tendon origin, the open approach, and the debridement performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 24358 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

24358 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$451.40
Alaska*Unavailable$604.83
ArizonaUnavailable$486.40
ArkansasUnavailable$445.37
AtlantaUnavailable$513.10
AustinUnavailable$509.52
BakersfieldUnavailable$510.50
Baltimore/Surr. CntysUnavailable$531.17
BeaumontUnavailable$475.33
BrazoriaUnavailable$490.18

24358 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
24358 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 24358 rate is calculated

Each of 24358’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 24358

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.49Practice expense 7.20Malpractice 1.28

14.9700 adjusted RVUs×$33.4009 conversion factor=$500.01

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 24358

24358 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 24358

Elbow tenotomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 24358

Elbow tenotomy

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

24358 without 50 · national facility

$500.01

Elbow tenotomy

24358-50 · Bilateral: 150%

$750.02

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

24358 compared with similar codes

Compare codes

24358 vs 24357 vs 24359 vs 24341: national Medicare rates

Swap in your local Medicare rate.

  • 24358
    Elbow tenotomy · 6.49 wRVU
    —
  • 24357
    Elbow tenotomy · 5.3 wRVU
    —
  • 24359
    Elbow tendon repair · 8.76 wRVU
    —
  • 24341
    Tendon/muscle repair · 9.25 wRVU
    —

How to choose

24357Elbow tenotomy
Choose 24357 for percutaneous treatment. This code is for open release with debridement.
24359Elbow tendon repair
Choose 24359 when the common extensor or flexor origin is detached and reattached. This code covers open release with debridement without that reattachment.
24341Tendon/muscle repair
24341 describes repair of a tendon or muscle in the upper arm or elbow. Use 24358 for open epicondylar release with debridement, not repair of a discrete tendon or muscle injury.

Codes related to 24358

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 24358
CodeHow it relatesNational office range
Same family
24357Elbow tenotomyPercutaneous approach for lateral or medial elbow tenotomy.No office rate
24359Elbow tendon repairOpen treatment that includes detachment and reattachment of the tendon origin.No office rate
Used instead
24341Tendon/muscle repairFor repair of a tendon or muscle lesion in the upper arm or elbow, rather than epicondylar debridement.No office rate

24358 billing questions

How does 24358 differ from 24357?

24358 describes an open operation with release and debridement. 24357 is the percutaneous approach.

When should 24359 be reported instead?

Use 24359 when the operative work includes detaching and reattaching the common extensor or flexor origin. Debridement with open release, without that reattachment, points to 24358.

What should the operative note document?

Document the side, lateral or medial tendon origin treated, open approach, and soft-tissue and/or bone debridement. The note should make clear whether the tendon origin was detached and reattached.

How is bilateral surgery reported?

When the procedure is performed on both elbows, report modifier 50 under the CMS bilateral rule; payment is at 150%.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 24358PPRRVU2026_Oct_nonQPP.csv, line 2,308 (RVU26D)

Open CMS sourceHow we calculate rates

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