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See a sample rate comparisonCPT 24365 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 24Ambulatory Surgical Center |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5115 - Level 5 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $605.56 national non-facility rate (2026)View Medicare rates for 24365 |
| Medicaid Fee Schedule | $482.99 median of the 8 states in the free previewView Medicaid rates for 24365 |
National average reimbursement for CPT 24365 by major payers:

$931.12
BCBS / Anthem

$863.02
UnitedHealthcare

$883.15
Aetna

$1,053.36
Cigna
Choose a payer to see a sample of rates for CPT 24365.
Cross Timbers Surgery Center, LLC, North Texas Gi Center
Cross Timbers Surgery Center, Lp Dba North Texas Gi Center
Lancaster Specialty Surgery Center
Lancaster Specialty Surgical Center
Peace River Surgery Center
Elite Endoscopy LLC
Triad Surgery Center LLC, Triad Eye Medical Clinic And Cataract Institute PLLC
Triad Eye Institute, PLLC
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 24365 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 24365. 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 24365. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 24365 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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Medicare's hospital outpatient payment system (OPPS) assigns CPT 24365 to APC 5115 (Level 5 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
CMS lists CPT 24365 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Hospital price transparency files list CPT 24365 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.