Billing code 24331: Elbow flexor-plastyMedicare rate & RVUs in Vermont

Reports advancement of the elbow flexor-pronator origin to improve elbow flexion, commonly for patients with substantial weakness of elbow flexion.

CMS RVU26DEffective Oct 1, 20261 payment locality

CMS doesn’t publish an office rate for 24331 in Vermont.

—Office (non-facility)
$693.68Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 24331 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Vermont
  2. What 24331 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

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.

24331 in Vermont

24331 office and facility rates by payment locality
Payment localityOfficeFacility
VermontUnavailable$693.68

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

21.9800 adjusted RVUs×$33.4009 conversion factor=$734.15

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share 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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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).

When to use modifier 50

24331 compared with similar codes

Compare codes

24331 vs 24330 vs 24301 vs 24305: national Medicare rates

Swap in your local Medicare rate.

  • 24331
    Elbow flexor-plasty · 10.68 wRVU
    —
  • 24330
    Elbow flexor-plasty · 9.55 wRVU
    —
  • 24301
    Tendon transfer · 10.12 wRVU
    —
  • 24305
    Tendon lengthening · 7.43 wRVU
    —

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
RVUs for 24331PPRRVU2026_Oct_nonQPP.csv, line 2,298 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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