No office rate
Use 24100 for open elbow-joint access with synovial biopsy only. Use 24101 when the documented service includes broader joint exploration or removal.
On this page
CMS RVU26D · Effective 2026-10-01
24100 Elbow biopsy Medicare reimbursement rates in Massachusetts
Reports open access to the elbow joint to obtain synovial tissue for biopsy when the operation does not include a broader joint procedure. Compare 24100 office and facility rates across CMS payment localities in Massachusetts.
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 24100 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$417.70–$454.82
2 of 2 localities have a supported rate.
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 24100: Open elbow synovial biopsy
Reports open access to the elbow joint to obtain synovial tissue for biopsy when the operation does not include a broader joint procedure.
The surgeon opens the elbow joint and removes synovial tissue for diagnostic examination. Orthopedic surgeons typically perform this procedure in a hospital or other surgical facility when tissue sampling is needed to investigate an abnormal joint lining, such as suspected inflammatory or infectious disease. The service is limited to obtaining the biopsy; it is not the code for a more extensive joint exploration or synovectomy.
Report the code when the operative note supports an open elbow-joint approach and synovial biopsy as the procedure performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, CMS pays 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 24100
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.94 · 40%
- Practice expense (office) RVU6.30 · 51%
- Malpractice RVU1.07 · 9%
17
Medicare services in 2024 · #5994 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.
24100 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
24102 describes elbow synovectomy, a therapeutic removal of synovial tissue; 24100 is for obtaining tissue samples for biopsy.
No office rate
24105 is for excision of the olecranon bursa, an extra-articular structure. This code is for synovial biopsy within the elbow joint.
Compare 24100 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$454.82
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$417.70
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24100 billing questions
When should this code be used instead of 24101?
Use this code for open elbow-joint access to obtain synovial tissue only. Code 24101 describes a broader joint exploration or removal service, with or without biopsy.
Does this code include the pathology examination?
It reports the surgeon’s procedure to obtain the tissue, not the pathologist’s examination. A separately performed pathology service may be reported by the appropriate laboratory or pathologist.
How does this differ from elbow synovectomy?
This code covers biopsy sampling of synovium. When the operation removes synovial tissue as a therapeutic synovectomy, consider 24102 instead.
What documentation supports reporting this service?
The operative report should establish an open approach to the elbow joint and removal of synovial tissue for biopsy. It should distinguish sampling from joint exploration, loose-body removal, or synovectomy.
How are bilateral procedures and multiple same-session procedures handled?
CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
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.
2,26324076,,Ex arm/elbow tum deep < 5 cm,A,,7.22,6.82,NA,6.82,,1.56,15.60,15.60,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,26424077,,Rad rescj tum tiss a/e <5cm,A,,15.33,9.82,NA,9.82,,3.53,28.68,28.68,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,26524079,,Rad rescj tum tiss a/e 5 cm+,A,,20.09,12.00,NA,12.00,,4.62,36.71,36.71,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,26624100,,Arthrt elbw synovial bx only,A,,4.94,6.30,NA,6.30,,1.07,12.31,12.31,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,26724101,,Arthrt elbw jt expl bx rmvl,A,,6.14,7.06,NA,7.06,,1.25,14.45,14.45,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,26824102,,Arthrt elbow w/synovectomy,A,,8.05,7.66,NA,7.66,,1.62,17.33,17.33,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,26924105,,Excision olecranon bursa,A,,3.69,6.28,NA,6.28,,0.75,10.72,10.72,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00