Billing code 24100: Elbow biopsyMedicare rate & RVUs in Oregon
Reports open access to the elbow joint to obtain synovial tissue for biopsy when the operation does not include a broader joint procedure.
CMS doesn’t publish an office rate for 24100 in Oregon.
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 9 sections
What 24100 covers
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.
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 24100 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $428.01 |
| Rest Of Oregon | Unavailable | $399.71 |
How the 24100 rate is calculated
Each of 24100’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 · 24100
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.94Practice expense 6.30Malpractice 1.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 24100
24100 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24100
Elbow biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 24100
Elbow biopsy
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
24100 without 50 · national facility
$411.17
Elbow biopsy
24100-50 · Bilateral: 150%
$616.76
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).
24100 compared with similar codes
Compare codes
24100 vs 24101 vs 24102 vs 24105: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 24101Elbow arthrotomy
- Use 24100 for open elbow-joint access with synovial biopsy only. Use 24101 when the documented service includes broader joint exploration or removal.
- 24102Elbow synovectomy
- 24102 describes elbow synovectomy, a therapeutic removal of synovial tissue; 24100 is for obtaining tissue samples for biopsy.
- 24105Bursa excision
- 24105 is for excision of the olecranon bursa, an extra-articular structure. This code is for synovial biopsy within the elbow joint.
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 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
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