Billing code 24160: Elbow prosthesis removalMedicare rate & RVUs in Oregon
Removal of the humeral and ulnar components of an elbow prosthesis, such as for infection or loosening when the procedure is explantation rather than revision.
CMS doesn’t publish an office rate for 24160 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 24160 covers
An orthopedic surgeon removes the prosthetic humeral and ulnar components from an elbow joint. The procedure may be performed when an elbow replacement is infected, loose, or otherwise requires removal without the work being a component revision. It is typically performed in a hospital or other surgical facility; Medicare recorded facility services for this code in 2024.
Report the code when the operative documentation supports removal of both specified components. If the surgeon revises the elbow replacement, distinguish that work from removal alone and select the applicable revision code based on the components revised. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. In a session with multiple procedures, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeon payment requires 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 24160 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,170.60 |
| Rest Of Oregon | Unavailable | $1,108.18 |
How the 24160 rate is calculated
Each of 24160’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 · 24160
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 18.16Practice expense 12.34Malpractice 3.88
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 24160
24160 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24160
Elbow prosthesis removal
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 24160
Elbow prosthesis removal
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
24160 without 50 · national facility
$1,148.32
Elbow prosthesis removal
24160-50 · Bilateral: 150%
$1,722.48
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).
24160 compared with similar codes
Compare codes
24160 vs 24164 vs 24370 vs 24371: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 24164Prosthesis removal
- Use 24164 for removal of a radial head prosthesis. This code is for removal of the humeral and ulnar components of an elbow prosthesis.
- 24370Elbow revision
- Use 24370 when the work is revision of both humeral and ulnar components of a total elbow arthroplasty, rather than removal alone.
- 24371Elbow revision
- Use 24371 for revision involving one component of a total elbow arthroplasty. This code describes removal of the humeral and ulnar components.
24160 billing questions
How is this different from removal of a radial head prosthesis?
This code covers removal of the humeral and ulnar components of an elbow prosthesis. Code 24164 is for removal of a radial head prosthesis.
Should this be reported with a total elbow revision code?
When the surgeon revises the prosthesis, choose the revision code that matches the components revised. Do not treat removal of the old components as automatically separately reportable.
What documentation supports reporting this code?
The operative report should identify the elbow prosthesis components removed and describe the removal performed. Include the clinical reason, such as infection or loosening, when documented.
How does Medicare handle bilateral reporting?
For bilateral procedures reported with modifier 50, Medicare pays this code at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeon payment is allowed 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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