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See a sample rate comparisonCPT 24343 Fee Schedule
Medicare rates as of October 2026
CPT 24343 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Repair Lateral Collateral Ligament, Elbow, With Local Tissue
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5113 - Level 3 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 03600960Sign up to view all 5 |
| Medicare Fee Schedule | $676.70 national non-facility rate (2026)View Medicare rates for 24343 |
| Medicaid Fee Schedule | $542.025 median of the 8 states in the free previewView Medicaid rates for 24343 |
National average reimbursement for CPT 24343 by major payers:
$926.30
BCBS / Anthem
$949.56
UnitedHealthcare
$1,008.16
Aetna
$1,171.26
Cigna
Compare published rates across providers.
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CPT 24343
5 of 25 sample ratesHigher to lower in this preview
El Paso Surgery Centers Lp
$8,266.00Published rateRome Orthopaedic Clinic Asc, Inc.
Rome Orthopaedic Clinic Asc Inc
$2,960.00Published ratePlastic Surgery Center Of St Joseph, Inc
Plastic Surgery Center Of St Joseph Inc
$1,622.00Published rateMae Physicians Surgery Center, LLC
Mae Physician'S Surgery Center, LLC
$1,226.92Published rateBrighton Surgery Center, LLC
$663.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 24343 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 24343. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 24340-CPT | Tenodesis Rupture Biceps At Elbow |
| 24342-CPT | Reinsert Of Rupture Biceps Or Triceps Tndon Distal W/ Or W/, Reinsertion Of Ruptured Biceps Or Triceps Tendon Distal With Or With |
| 24343-CPT | Repair Lateral Collateral Ligament, Elbow, With Local Tissue |
| 24344-CPT | Reconstruct Elbow Lat Ligmnt, Reconstruction Lateral Collateral Ligament Elbow With Tendon Graft Includes Harvesting Of Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 24343. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 24343 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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Frequently Asked Questions
What APC is CPT 24343 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 24343 to APC 5113 (Level 3 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 24343 in an ambulatory surgery center?
CMS lists CPT 24343 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 24343?
Hospital price transparency files list CPT 24343 under these revenue codes: 0360, 0960, 0761, 0490 and 0975. A revenue code names the hospital department or charge category for the line; it does not change what the service is.