Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 24363 Fee Schedule
Medicare rates as of October 2026
CPT 24363 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Arthroplst Elbow; W/ Distal Humerus & Proxim Ulnar Prosthet, Arthroplasty Elbow; With Distal Humerus And Proximal Ulnar Prosthetic
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 21Inpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight 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 | $1,300.63 national non-facility rate (2026)View Medicare rates for 24363 |
| Medicaid Fee Schedule | $1,034.45 median of the 8 states in the free previewView Medicaid rates for 24363 |
National average reimbursement for CPT 24363 by major payers:
$1,993.08
BCBS / Anthem
$1,964.25
UnitedHealthcare
$2,039.67
Aetna
$2,366.42
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 24363.
CPT 24363
5 of 25 sample ratesHigher to lower in this preview
North Valley Orthopedic Surgery Center LLC, The Orthopedic Surgery Center Of Arizona
North Valley Orthopedic Surgery Center LLC
$29,434.00Published rateAz West Endoscopy Center LLC
$9,510.00Published rateNorthpointe Surgical Suites, LLC
$5,500.00Published ratePenn State Hershey Endoscopy Center LLC
$3,454.00Published rateAtlanta Endoscopy Center
$1,111.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Looking for other data?
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 24363 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 24363. 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). |
| 24362-CPT | Arthroplst Elbow; W/ Implnt & Fascia Lata Ligamnt Reconstruc, Arthroplasty Elbow; With Implant And Fascia Lata Ligament Reconstruct |
| 24363-CPT | Arthroplst Elbow; W/ Distal Humerus & Proxim Ulnar Prosthet, Arthroplasty Elbow; With Distal Humerus And Proximal Ulnar Prosthetic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 24363. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 24363 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 24363) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
What APC is CPT 24363 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 24363 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 24363 in an ambulatory surgery center?
CMS lists CPT 24363 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 24363?
Hospital price transparency files list CPT 24363 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.