Billing code 24342: Tendon repairMedicare rate & RVUs in Utah
Reports operative repair of a ruptured distal biceps or triceps tendon at the elbow, including primary or secondary repair and graft use when performed.
CMS doesn’t publish an office rate for 24342 in Utah.
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 24342 covers
This procedure repairs a ruptured distal biceps or triceps tendon near the elbow, typically by an orthopedic surgeon in an operating room. The surgeon restores tendon continuity and attachment; a graft may be used when needed. Common situations include a distal biceps rupture after lifting or a triceps rupture after an injury, when operative repair is selected.
Report the code for repair of the ruptured distal biceps or triceps tendon, whether the repair is primary or secondary; document the tendon, side, rupture, operative work, and any graft used. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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.
24342 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $691.41 |
How the 24342 rate is calculated
Each of 24342’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 · 24342
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.59Practice expense 8.74Malpractice 2.11
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 24342
24342 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24342
Tendon repair
| 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 · 24342
Tendon repair
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
24342 without 50 · national facility
$716.12
Tendon repair
24342-50 · Bilateral: 150%
$1,074.18
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).
24342 compared with similar codes
Compare codes
24342 vs 24341 vs 24340 vs 24343: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 24341Tendon/muscle repair
- Choose 24342 for a ruptured distal biceps or triceps tendon. Use 24341 for repair of another tendon or muscle in the upper arm or elbow.
- 24340Biceps tenodesis
- 24340 describes biceps tendon tenodesis at the elbow. 24342 is for repair of a ruptured distal biceps or triceps tendon.
- 24343Elbow ligament repair
- 24343 addresses repair of the lateral elbow ligament with tissue; 24342 repairs a distal biceps or triceps tendon.
24342 billing questions
When should 24342 be used instead of 24341?
Use 24342 for repair of a ruptured distal biceps or triceps tendon at the elbow. Code 24341 covers repair of other upper-arm or elbow tendons or muscles, reported for each tendon or muscle.
Is a graft included in 24342?
Yes. The code includes graft use when performed as part of the distal biceps or triceps tendon repair.
How is bilateral repair reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon be reported?
CMS allows payment for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Are routine postoperative visits separately reported?
Related postoperative care during the 90-day global period is included, along with the day-before preoperative visit.
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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