No office rate
Choose 24357 for percutaneous treatment. This code is for open release with debridement.
On this page
CMS RVU26D · Effective 2026-10-01
24358 Elbow tenotomy Medicare reimbursement rates in Iowa
Open elbow surgery for lateral or medial epicondylitis that releases the affected tendon and debrides diseased soft tissue or bone. Compare 24358 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 24358 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$453.79
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 24358: Open epicondylar tenotomy with debridement
Open elbow surgery for lateral or medial epicondylitis that releases the affected tendon and debrides diseased soft tissue or bone.
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.
CMS billing rules for 24358
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.49 · 43%
- Practice expense (office) RVU7.20 · 48%
- Malpractice RVU1.28 · 9%
709
Medicare services in 2024 · #3250 by national volume
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.
24358 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
Choose 24359 when the common extensor or flexor origin is detached and reattached. This code covers open release with debridement without that reattachment.
No office rate
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.
Compare 24358 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$453.79
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 24358 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,308
- Code
- 24358
- Physician work
- 6.49
- Practice expense
- 7.20
- Malpractice
- 1.28
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.49 | × 1.000 | 6.4900 |
| Practice expense | 7.20 | × 0.915 | 6.5880 |
| Malpractice | 1.28 | × 0.397 | 0.5082 |
| Total RVUs | 13.5862 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$453.79
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.49 | 1 |
| Practice expense | 7.2 | 0.915 |
| Malpractice | 1.28 | 0.397 |
(6.49 × 1 + 7.2 × 0.915 + 1.28 × 0.397) × $33.4009 = $453.79
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,30524345,,Repr elbw med ligmnt w/tissu,A,,8.93,9.45,NA,9.45,,1.82,20.20,20.20,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,30624346,,Reconstruct elbow med ligmnt,A,,14.83,12.86,NA,12.86,,3.16,30.85,30.85,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,30724357,,Repair elbow perc,A,,5.30,5.59,NA,5.59,,0.62,11.51,11.51,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,30824358,,Repair elbow w/deb open,A,,6.49,7.20,NA,7.20,,1.28,14.97,14.97,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,30924359,,Repair elbow deb/attch open,A,,8.76,7.97,NA,7.97,,1.74,18.47,18.47,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31024360,,Reconstruct elbow joint,A,,12.35,10.11,NA,10.11,,2.62,25.08,25.08,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31124361,,Reconstruct elbow joint,A,,14.05,10.81,NA,10.81,,3.00,27.86,27.86,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136