Unlisted code for an open procedure on the humerus or elbow that has no specific CPT code.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- Elbow
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 2 cited references ↓
- Operative note with approach, structures treated, and fixation
- Reason no listed elbow or humerus code applies
- Comparison code and reasoning
- Laterality
- Implants or grafts used
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 2 cited references ↓
24999 is the unlisted code for the upper arm and elbow. It applies to open or percutaneous work on the humerus, elbow joint, and surrounding soft tissue when nothing in the humerus and elbow section fits. Elbow arthroscopy with no code goes to 29999 instead.
In practice it comes up with newer ligament reconstruction techniques, custom implant procedures, and unusual combinations that a single listed code does not capture. Before using it, confirm the work is not a listed code with a different graft or anchor. Payers often push back on an unlisted claim when the op note reads like a listed procedure with a newer device, so explain in the letter what makes the work different.
Medicare has no fee and a YYY global. Send the op note, a cover letter, and a comparison code. Include laterality. Surgeons who split a case with another surgeon should document each surgeon's portion separately.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
HOPD (APC 5111) Hospital outpatient department | $252.01 |
Common denial reasons
The recurring reasons claims for CPT 24999 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Elbow arthroscopy billed under open unlisted code
- A listed code describes the work
- No comparison code or op note sent
- Missing laterality
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01When should I use CPT 24999?
02Does 24999 have a global period?
03What should a 24999 cover letter include?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c12.pdf
Mira Scribe
Mira Scribe writes out the approach, side, grafts, and fixation in order, which is the detail payers need to price an unlisted elbow case.
See how Mira captures CPT 24999 documentation