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See a sample rate comparisonCPT 24361 Fee Schedule
Medicare rates as of October 2026
CPT 24361 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Elbow Replacement Surgery, Surgery To Replace Damaged Ends Of The Elbow Joint With New Tissue Or An Artificial Part (Prosthesis).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 21Inpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5116 - Level 6 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $930.55 national non-facility rate (2026)View Medicare rates for 24361 |
| Medicaid Fee Schedule | $739.955 median of the 8 states in the free previewView Medicaid rates for 24361 |
National average reimbursement for CPT 24361 by major payers:
$1,375.25
BCBS / Anthem
$1,362.56
UnitedHealthcare
$1,383.03
Aetna
$1,650.27
Cigna
Compare published rates across providers.
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CPT 24361
5 of 25 sample ratesHigher to lower in this preview
East Texas Medical Center Carthage, Etmc Carthage
$15,497.00Published rateHagerstown Surgery Center,LLC
Hagerstown Surgery Center, LLC
$9,650.00Published rateAscension Saint Thomas Lebanon Surgery Center LLC, Lebanon Surgery Center
$8,492.00Published rateNei Ambulatory Surgery Center Inc PC
$3,920.00Published rateAdvanced Dermatology And Skin Surgery, PLLC
$1,064.00Published rate
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See a sample payer proposalCPT 24361 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 24361. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 24360-CPT | Elbow Replacement Surgery, Surgery To Replace Damaged Ends Of The Elbow Joint With New Tissue Or An Artificial Part (Prosthesis). |
| 24361-CPT | Elbow Replacement Surgery, Surgery To Replace Damaged Ends Of The Elbow Joint With New Tissue Or An Artificial Part (Prosthesis). |
| 24363-CPT | Arthroplst Elbow; W/ Distal Humerus & Proxim Ulnar Prosthet, Arthroplasty Elbow; With Distal Humerus And Proximal Ulnar Prosthetic |
| 24365-CPT | Reshape Bones Of The Elbow, Surgery To Reshape The End Of The Elbow Joint By Grinding Down The Surface. The Procedure Is Done To Allow Growth Of New Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 24361. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 24361 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 24361 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 24361 to APC 5116 (Level 6 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 24361 in an ambulatory surgery center?
CMS lists CPT 24361 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 24361?
Hospital price transparency files list CPT 24361 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.