CPT code 24152: Radical resection of tumor, radial head or neck

Key takeaways

CPT code 24152 covers radical resection of a tumor of the radial head or neck. It is a radius procedure, not a humerus one.

The code is filed under Excision Procedures on the Humerus (Upper Arm) and Elbow, a subsection that spans the whole elbow region.

Report 24150 for a shaft or distal humerus tumor, and 25170 for a tumor further down the radius or ulna.

CPT 24153 was deleted effective January 1, 2010. It once covered the autograft version of 24152 and is no longer billable.

The code carries a 90-day global surgical period, so most routine post-operative care is bundled into the base payment.

Practice management software like Pabau validates modifiers and reconciles ERAs through its Claim.MD integration, which keeps complex surgical claims moving.

CPT code 24152 describes radical resection of a tumor of the radial head or neck. Per the American Medical Association’s CPT code set, the official descriptor reads: Radical resection of tumor, radial head or neck. The bone involved is the proximal radius, at the elbow end of the forearm.

That surprises a lot of coders, because 24152 is filed under the CPT subsection headed Excision Procedures on the Humerus (Upper Arm) and Elbow. The subsection covers the whole elbow region, including the proximal radius and the olecranon. The heading names the humerus, but the individual descriptor is what governs code selection.

Radical resection means en bloc removal of the bone tumor along with a cuff of normal surrounding soft tissue. That wide margin is what separates 24152 from curettage and from lesser excision codes on the same bone, such as 24120 and 24145.

What CPT code 24152 covers

The surgeon exposes the proximal radius, then removes the radial head or neck. A margin of healthy bone and soft tissue comes out around the tumor. The goal is margin control rather than clearance of the visible lesion alone. Reconstruction, prosthetic replacement, or graft placement is reported separately when performed.

Orthopedic oncology surgeons use the code most often. Typical indications include a primary bone sarcoma of the proximal radius or an aggressive benign lesion such as a giant cell tumor. A metastatic deposit that has destroyed the radial head also qualifies. A code this specific fails on small documentation details, which is where medical billing fundamentals earn their keep.

When 24152 is the right code

• The operative note names the radial head or radial neck as the resected bone.
• The tumor was removed en bloc with a cuff of surrounding normal tissue.
• Pathology supports a malignant, metastatic, or aggressive lesion of bone.

When 24152 is the wrong code

• The resection was on the humerus. Report 24150 instead.
• The tumor sat in the radial shaft or the ulna. Report 25170 instead.
• The surgeon curetted a bone cyst or a benign tumor of the radial head or neck. Report 24120.
• The radial head was excised for fracture or arthritis rather than tumor. Report 24130.

Reimbursement rates and RVUs for 24152

Reimbursement for CPT code 24152 varies by geographic location, payer, and facility type. Medicare payment is calculated using the Medicare Physician Fee Schedule (MPFS) and adjusted by the Geographic Practice Cost Index (GPCI) for each MAC region. Use the CMS Physician Fee Schedule lookup tool to retrieve current rates for your locality.

Medicare facility vs. non-facility rates

CPT code 24152 is billed under two rate categories, depending on where the procedure is performed. Facility rates apply in a hospital or an ambulatory surgical center (ASC). Non-facility rates apply in a physician office, though radical resection of the radial head is almost always done in a facility.

Verify the current year’s fee schedule amounts with CMS before quoting expected reimbursement. Rates change annually with each MPFS update.

The three RVU components

RVUs determine how Medicare calculates payment. CPT code 24152 carries three RVU components. Work RVU covers physician effort and skill, practice expense RVU covers staff and supplies, and malpractice RVU covers professional liability. The CMS lookup tool above returns the current values for the code by locality.

CMS publishes the conversion factor each year in the MPFS final rule. Payment equals total RVU multiplied by the conversion factor, with GPCI adjustments applied. Radical resection codes such as 24152 carry substantial work RVUs, given the operative time and the margin planning involved.

Modifiers that apply to CPT code 24152

Modifier selection for CPT code 24152 affects both reimbursement accuracy and audit risk. Each modifier needs documentation behind it. Applying one without matching operative note language is a top denial trigger for high-complexity surgical codes.

Check modifier -51 exempt status for CPT 24152 against current AMA CPT guidance and your payer’s own policy. Some payers apply their own rules independently of the AMA modifier -51 exempt list.

The 90-day global period

CPT code 24152 carries a 90-day global surgical period. Medicare and most commercial payers bundle routine post-operative care into the code’s base payment for 90 days after surgery. Billing an included service separately inside that window triggers an automated denial.

What is included in the 90-day global period

• Pre-operative visits on the day of surgery or the day before
• Intra-operative services integral to the resection
• Complications and follow-up visits directly related to the procedure
• Routine post-operative dressing changes and wound checks
• Removal of surgical sutures or staples

What can be billed separately during the global period

• Visits for an unrelated condition or a new problem not caused by the surgery
• Diagnostic tests ordered for reasons unrelated to the operative site
• A complication requiring return to the operating room (modifier -78)
• A staged or related procedure planned before the original surgery (modifier -58)
• Services from a different physician who did not perform the resection

Modifier -24 covers an unrelated E/M during the post-operative period, and modifier -79 covers an unrelated procedure. Both need documentation showing the service is genuinely separate from the resection.

ICD-10 codes that pair with 24152

Every surgical claim for CPT code 24152 needs at least one ICD-10-CM diagnosis code that supports medical necessity. Because the radius is a long bone of the upper limb, the relevant neoplasm codes sit in the C40.0- and D16.0- families. Payers use the linked diagnosis to decide coverage, so specificity matters.

Laterality matters, and the convention is easy to check. Right-side codes in these families end in 1, and left-side codes end in 2. A claim that carries an unspecified laterality code when the operative report names the side is often flagged or denied.

Note that C40.1- covers short bones of the upper limb, meaning the carpals, metacarpals, and phalanges. It does not describe the radius, so it should not appear on a 24152 claim.

NCCI edits and bundling rules

The National Correct Coding Initiative (NCCI) sets out which procedure codes cannot be billed together without documentation of a distinct service. For CPT code 24152, the usual Column 2 candidates are lesser procedures on the same bone, plus biopsies taken through the same approach.

NCCI tables update quarterly. The pairs below reflect common bundling patterns for major excision codes around the elbow. Verify the current tables in the CMS NCCI Policy Manual before you bill. Reading up on denial codes in medical billing helps when a bundling denial does land.

When modifier -59 unbundles an NCCI pair, the operative note must describe the separate anatomical location or the independent clinical reason for the second service. Applying -59 without that language is a compliance risk.

Related CPT codes: Choosing the right excision code around the elbow

CPT code 24152 sits in a tight group of excision codes. They differ by which bone was cut, and by how much of it came out. Getting either one wrong sends the claim to the wrong code family.

Two questions settle the choice. Answer the bone first, then the extent. The sibling page on CPT code 24115 walks through the same decision on the humerus side of the family.

Two of these deserve a second look. CPT 24151 was deleted alongside 24153 on January 1, 2010, when the autograft variants across this family were retired. Neither code should appear on a claim today.

There is also no radical resection code specific to the olecranon process. The family offers 24147 for partial excision of the olecranon, but no code at radical extent. When a surgeon radically resects an olecranon tumor, check payer guidance and consider the unlisted procedure code 24999 with a full operative note.

Billing guidelines and common documentation errors

Denials for CPT code 24152 cluster around a small set of recurring documentation failures. A pre-submission checklist built for radical resection codes prevents most of them.

Documentation requirements

• The bone is named: The operative note must identify the radial head or radial neck as the resected site. A note that says only “elbow” or “proximal forearm” invites a downcode.
• The extent is named: The note must state that the tumor came out with a cuff of normal tissue around it. Words like “curettage” or a bare “excision” will not support 24152.
• Laterality is specified: Right or left must appear in the operative report, the ICD-10 code, and any -RT or -LT modifier.
• Pathology report on file: Most payers want a pathology report confirming the diagnosis code. Send it with the claim when pre-authorization was required.
• Support for modifier -22: If you bill increased services, the note needs specific language on what made the case harder. Tumor size, nerve or vessel involvement, and documented extra operative minutes all help.

Common denial reasons

• The wrong bone: A proximal radius resection reported as 24150, or a humerus resection reported as 24152. The shared subsection heading is what causes this swap.
• Diagnosis does not support medical necessity: A benign neoplasm code where payer policy expects a malignant or aggressive diagnosis. Check LCD and NCD criteria before submission.
• Missing or mismatched laterality: The ICD-10 laterality does not match the operative report side. Automated claim edits reject this.
• Unbundling without support: Billing a bone biopsy code such as 20220 or 20240 alongside 24152 with no separate-site documentation.
• Global period error: Submitting a post-op wound check inside 90 days as though it were separately payable.

How Pabau keeps radial head resection claims clean

In a typical practice, the operative note lives in one system and the claim is keyed into another. The coder reads the note, picks 24152, then retypes the diagnosis, the laterality, and the modifiers. Each retype is a chance for the side to flip or a modifier to go missing.

Pabau is practice management software that keeps the clinical record and the claim in one place. The note, the diagnosis code, and the procedure code stay attached to one patient record. The coder works from the source rather than a copy.

From there, Pabau’s claims management software handles the submission side. Claims go out as 837P files through the Claim.MD integration, eligibility is checked before the visit, and ERAs post back against the original claim. That means fewer keying errors on high-value surgical codes, and a shorter path from surgery to payment.

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Conclusion

CPT code 24152 is a radius code that lives under a humerus heading, and that single fact drives most of the miscoding around it. Read the descriptor, not the subsection title. Confirm the operative note names the radial head or neck, and that it describes a wide en bloc margin. Then match laterality across the note, the ICD-10 code, and the modifier.

Get those three right and the claim usually clears on the first pass. For practices handling high-complexity orthopedic billing, keeping the note and the claim in one platform removes the retyping that causes the rest. See how Pabau handles this by visiting book a demo.

Continue your research

Need a framework for understanding medical billing compliance? Medical billing compliance guide covers documentation standards, audit risks, and payer policy alignment for surgical claims.

Want to understand how clearinghouse submissions work? 837 file submission guide explains the 837P electronic claim format used for physician billing, including surgical procedures.

Managing revenue cycle workflows across your practice? Revenue cycle management overview covers how billing, coding, submission, and reconciliation connect from service delivery to payment.

Chasing denials on orthopedic surgical claims? Denial management in healthcare sets out how to triage, appeal, and prevent the denials that surgical coding generates.

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