CPT 24079 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 24079 |
| Medicaid Fee Schedule | View Medicaid rates for 24079 |
National average reimbursement for CPT 24079 by major payers:
$1,747.62
$1,808.92
$1,876.05
$2,171.09
CPT 24079 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 24079 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 24079 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 24071-CPT | Moderate | Xcision Tumor Sft Tissue Of Upper Arm Elbow Area Subcutane, Excision Tumor Soft Tissue Of Upper Arm Or Elbow Area Subcutaneous; |
| 24075-CPT | Moderate | Xcision Tumor Sft Tissue Of Upper Arm Elbow Area Subcutane, Excision Tumor Soft Tissue Of Upper Arm Or Elbow Area Subcutaneous; |
| 24076-CPT | Moderate | Ex Arm Elbow Tum Deep 5 Cm, Excision Tumor Soft Tissue Of Upper Arm Or Elbow Area Subfascial Eg Intramuscular Less Than 5 Cm |
| 24079-CPT | High | Radical Resection Of Tumor (Eg, Radical Resection Of Tumor (Eg Malignant Neoplasm) Soft Tissue Of Upper Arm Or Elbow Area 5 Cm Orgreater |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 24079. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 24079 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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