No office rate
24360 describes interposition arthroplasty. Choose 24361 when the operation replaces the distal humerus with a prosthetic component.
On this page
CMS RVU26D · Effective 2026-10-01
24361 Elbow arthroplasty Medicare reimbursement rates in Virginia
Reports elbow reconstruction using a prosthetic replacement of the distal humerus, rather than an interposition procedure or total elbow replacement. Compare 24361 office and facility rates across CMS payment localities in Virginia.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 24361 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$894.95–$1031.48
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 24361: Elbow arthroplasty with distal humeral replacement
Reports elbow reconstruction using a prosthetic replacement of the distal humerus, rather than an interposition procedure or total elbow replacement.
This operation reconstructs the elbow by replacing the distal end of the humerus with a prosthetic component. An orthopedic surgeon typically performs it in a hospital or ambulatory surgical setting when the planned reconstruction calls for distal humeral prosthetic replacement. The operative report should make clear which part of the joint was reconstructed and that the distal humerus was replaced with a prosthesis.
Select this code based on the documented procedure, not simply the diagnosis or presence of an implant. Distinguish it from interposition arthroplasty, other implant-and-graft techniques, and total elbow replacement. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one 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 services may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 24361
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.05 · 50%
- Practice expense (office) RVU10.81 · 39%
- Malpractice RVU3.00 · 11%
23
Medicare services in 2024 · #5836 by national volume
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.
24361 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
24362 identifies a different implant-and-graft elbow arthroplasty approach. Use the operative details to distinguish it from distal humeral prosthetic replacement.
No office rate
24363 is for total elbow replacement. This code is for reconstruction with distal humeral prosthetic replacement, not the total elbow procedure.
No office rate
24370 describes revision of an elbow reconstruction. It applies to revision surgery, not the initial distal humeral prosthetic replacement.
Compare 24361 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1031.48
Virginia →
Office / nonfacility
Unavailable
Facility
$894.95
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24361 billing questions
How does this differ from total elbow replacement?
This code describes reconstruction using a prosthetic replacement of the distal humerus. Total elbow replacement is reported with 24363.
How should this be distinguished from 24360?
Use 24360 for an interposition arthroplasty. Use 24361 when the documented reconstruction replaces the distal humerus with a prosthetic component.
What operative documentation supports this code?
Document the elbow reconstruction, the distal humeral portion replaced, and the use of a prosthetic component. The operative report should distinguish the work from interposition or total elbow replacement.
How is bilateral surgery reported?
When both elbows are treated in the same session, modifier 50 identifies the bilateral procedure; CMS pays it at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,30824358,,Repair elbow w/deb open,A,,6.49,7.20,NA,7.20,,1.28,14.97,14.97,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,30924359,,Repair elbow deb/attch open,A,,8.76,7.97,NA,7.97,,1.74,18.47,18.47,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31024360,,Reconstruct elbow joint,A,,12.35,10.11,NA,10.11,,2.62,25.08,25.08,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31124361,,Reconstruct elbow joint,A,,14.05,10.81,NA,10.81,,3.00,27.86,27.86,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31224362,,Reconstruct elbow joint,A,,14.94,11.10,NA,11.10,,3.18,29.22,29.22,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31324363,,Replace elbow joint,A,,21.45,13.16,NA,13.16,,4.33,38.94,38.94,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31424365,,Reconstruct head of radius,A,,8.40,7.95,NA,7.95,,1.78,18.13,18.13,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00