CPT 24359 Fee Schedule
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.
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 24359 |
| Medicaid Fee Schedule | View Medicaid rates for 24359 |
National average reimbursement for CPT 24359 by major payers:
$861.68
$879.75
$935.50
$1,092.83
CPT 24359 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 24359 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 24359 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 |
|---|---|---|
| 24300-CPT | Moderate | Manipulation, Elbow, Under Anesthesia |
| 24341-CPT | High | Rpr Tdn Musc Upr A E Each, Repair Tendon Or Muscle Upper Arm Or Elbow Each Tendon Or Muscle Primary Or Secondary Excludes Rotator Cuff |
| 24343-CPT | Moderate | Repair Lateral Collateral Ligament, Elbow, With Local Tissue |
| 24359-CPT | Moderate | Repair Elbow Deb Attch Open, Tenotomy Elbow Lateral Or Medial Eg Epicondylitis Tennis Elbow Golfer S Elbow Debridement Soft Tissue And Or Bone Open With Tendon Repair Or Reattachment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 24359. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 24359 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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