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See a sample rate comparisonCPT 24164 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Remval Of Prosthes Inclu Debrideme & Synovectomy When Perfo, Removal Of Prosthesis Includes Debridement And Synovectomy When Perfo
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 24164 |
| Medicaid Fee Schedule | View Medicaid rates for 24164 |
National average reimbursement for CPT 24164 by major payers:
$938.26
$878.66
$943.04
$1,115.47
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CPT 24164
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Richmond, LLC, Memorial Hermann Surgery Center Richmond
$7,838.00Published rateRiverside Ambulatory Surgery Center, LLC, The Endoscopy & Colonoscopy Center
Riverside Ambulatory Surgery Center LLC
$3,570.00Published rateAsc Development Company, LLC
Asc Development Company LLC
$1,763.00Published rateSouthwestern Eye Center Ltd, Southwestern Eye Center
Southwestern Eye Center, Ltd.
$1,410.00Published rateSystem Optics LLC
System Optics, Inc.
$662.00Published rate
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See a sample payer proposalCPT 24164 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 24164 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 24164 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 |
|---|---|---|
| 24006-CPT | Moderate | Arthrotomy Of The Elbow W/ Capsulr Xcision For Capsulr Rlease, Arthrotomy Of The Elbow With Capsular Excision For Capsular Release ( |
| 24100-CPT | Moderate | Elbow Surgery, Surgery To Explore The Elbow Joint And Remove A Sample Of Tissue For Testing (Biopsy). The Procedure May Include Removing Bone Chips Or Loose Cartilage. |
| 24160-CPT | High | Removal Of Prosthesis Includes Debridement And Synovectomy When Performed; Humeral And Ulnar Components (Revised 01/01/2014) |
| 24164-CPT | Moderate | Remval Of Prosthes Inclu Debrideme & Synovectomy When Perfo, Removal Of Prosthesis Includes Debridement And Synovectomy When Perfo |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 24164. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 24164 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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