Billing code 24331: Elbow flexor-plastyMedicare rate & RVUs in Pennsylvania
Reports advancement of the elbow flexor-pronator origin to improve elbow flexion, commonly for patients with substantial weakness of elbow flexion.
CMS doesn’t publish an office rate for 24331 in Pennsylvania.
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 24331 covers
In this operation, the surgeon advances the flexor-pronator muscle origin on the upper arm to increase its leverage for elbow flexion. A classic use is a Steindler-type procedure for significant elbow-flexion weakness, including weakness after brachial plexus injury or polio. An orthopedic or hand surgeon typically performs the procedure in an operating room. The operative report should make clear that the flexor origin was advanced, rather than merely lengthened, released, or transferred to another site.
Report this code when the documented procedure includes advancement of the elbow flexor origin; the non-advancement flexor-plasty is a distinct sibling code. Documentation should identify the operative side, indication, structures advanced, and the work performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon and team-surgery payment 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 24331 pays more and less in Pennsylvania
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Philadelphia | Unavailable | $767.57 |
| Rest Of Pennsylvania | Unavailable | $705.25 |
How the 24331 rate is calculated
Each of 24331’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 · 24331
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.68Practice expense 9.03Malpractice 2.27
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 24331
24331 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24331
Elbow flexor-plasty
| 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) | 0 | Not permitted. |
| 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 · 24331
Elbow flexor-plasty
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
24331 without 50 · national facility
$734.15
Elbow flexor-plasty
24331-50 · Bilateral: 150%
$1,101.23
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).
24331 compared with similar codes
Compare codes
24331 vs 24330 vs 24301 vs 24305: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 24330Elbow flexor-plasty
- Choose 24331 when the flexor-plasty includes advancement of the flexor origin. Code 24330 describes the related flexor-plasty without that advancement distinction.
- 24301Tendon transfer
- 24301 describes a muscle or tendon transfer in the upper arm or elbow. This code is for advancing the elbow flexor origin as a flexor-plasty.
- 24305Tendon lengthening
- 24305 is for tendon lengthening in the upper arm or elbow. Use this code when the operative work advances the elbow flexor origin instead.
24331 billing questions
How does this differ from 24330?
This code is for elbow flexor-plasty with advancement of the flexor origin. Use 24330 for the related flexor-plasty without that advancement.
What operative documentation supports this code?
The report should describe advancement of the flexor-pronator origin, the operative side, and the clinical reason for improving elbow flexion.
Can both elbows be reported?
For bilateral surgery, CMS pays this procedure at 150% when reported with modifier 50.
How does payment work when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple-procedure reduction.
Is an assistant at surgery payable?
CMS permits assistant-at-surgery payment for this procedure. Co-surgeon and team-surgery payment are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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