HCPCS code J0970: Deleted estradiol valerate injection code
Most billing denials tied to deleted HCPCS codes come from one source: a code th...
Last Updated: August 18, 2026
Key takeaways
CPT code 24340 covers tenodesis of the biceps tendon at the elbow, performed as a separate procedure.
CPT 24342 covers a completely ruptured tendon, while 24340 covers one that is intact or partially torn.
The separate procedure designation means 24340 should not be billed alongside a more comprehensive elbow procedure without modifier support.
Common modifiers include -LT and -RT for laterality, -51 for multiple procedures, and -59 when NCCI edits apply.
Practice management software like Pabau links the operative note to claim generation, cutting manual CPT and ICD-10 transcription errors.
CPT code 24340 is the procedure code for tenodesis of the biceps tendon at the elbow, performed as a separate procedure. The official AMA descriptor reads: Tenodesis of biceps tendon at elbow (separate procedure).
The code sits in the CPT musculoskeletal system chapter. Its subsection covers repair, revision, and reconstruction of the humerus and elbow, spanning 24300 to 24498. Tenodesis stabilizes the biceps tendon by anchoring it to bone or adjacent tissue.
It does not fully reattach a ruptured end, which is what separates it from reinsertion procedures. The separate procedure designation is part of the official descriptor and carries the billing consequences covered below. For orthopedic teams handling sports medicine billing, 24340 is one of the foundational elbow repair codes to track.
Clinical indications for CPT 24340
Payers expect the operative note to support tenodesis rather than reinsertion. These are the diagnoses that most often justify CPT code 24340:
- Partial biceps tendon tear at the elbow with persistent instability that has not responded to conservative management
- Degenerative tendinopathy of the distal biceps tendon causing pain and functional limitation
- Biceps tendon instability or subluxation at the elbow joint
- Failed conservative treatment, including physical therapy and a steroid injection billed under CPT 20550
- Intraoperative finding of tendon degeneration that needs stabilization during a related elbow procedure
Document each indication in the pre-operative assessment and confirm it in the operative report. Vague language like “elbow pain” or “tendon pathology” without a linked diagnosis code raises denial risk sharply.
Which modifiers apply to CPT 24340
A laterality modifier applies to every unilateral 24340 claim, with -51 or -59 on top where the encounter calls for it. Modifier choice depends on how many procedures were performed and whether NCCI bundling edits are triggered. The wrong modifier, or a missing one, is a primary cause of rejection for this code.
The Office of Inspector General (OIG) treats incorrect modifier -59 usage as a high-audit-risk area. Only apply -59 when the procedures are genuinely distinct and the operative note explains the basis for that distinction. The AAPC Codify platform provides current NCCI edit pair lookups, so you can check -59 before the claim goes out.
ICD-10 codes used with CPT code 24340
Every 24340 claim needs a linked ICD-10-CM diagnosis code that supports medical necessity. Payers read that code to confirm tenodesis was the clinically appropriate procedure. The codes below are the ones most often paired with a 24340 claim. Check current-year validity with the CMS Physician Fee Schedule before submitting.
If the operative note describes a different biceps injury pattern, check the neighboring codes in the S46 series, such as S46.191A. The M77.2 series is a common mis-pick here, because those codes describe the wrist rather than the elbow.
Use CrossCoder to verify current crosswalk pairings. It also shows whether your diagnosis code carries an active Local Coverage Determination (LCD) from your Medicare Administrative Contractor (MAC). Practice management software like Pabau keeps that link inside the encounter itself.
Its claims management tools let coders attach ICD-10 codes to CPT codes as the note is written. The pairing never has to be re-typed into a separate billing system.
Medicare reimbursement and RVU values for CPT 24340
Medicare pays CPT 24340 through the Physician Fee Schedule RVU methodology. The national rate is the total RVU multiplied by the annual conversion factor. A geographic practice cost index (GPCI) then adjusts that figure for your locality.
Payment also changes with the place of service, so a hospital case and an office case are not worth the same amount.
RVU breakdown for CPT 24340
The table below shows the components behind that payment. Use the FastRVU lookup tool to pull current-year values for your locality, since CMS updates the components and the conversion factor every year.
Non-facility rates, which apply to office-based procedures, are typically higher than facility rates. The practice expense RVU covers overhead that a hospital or ASC absorbs itself in the facility setting.
Confirm which setting applies before you submit. Billing teams should also confirm locality-adjusted rates with their MAC before using national figures in a revenue projection.
Pro Tip
Run your CPT 24340 claims through a facility versus non-facility rate check before submission. If the procedure happened in a hospital or ASC, the lower facility PE RVU applies. Submitting the non-facility rate for a facility-based procedure triggers automatic downcoding, and the shortfall can take weeks to resolve.
CPT 24340 vs. CPT 24342: Key differences for coders
The most common miscoding error for elbow biceps procedures is swapping 24340 for 24342. Tenodesis (24340) stabilizes a tendon that is intact or partially torn. Reinsertion (24342) reattaches a tendon that has completely ruptured from its insertion.
Using 24342 for a tenodesis procedure, or the reverse, is an audit trigger the OIG has flagged in orthopedic billing reviews.
When the operative report describes both stabilization and reattachment, code the primary procedure first. If the surgeon found a complete rupture and performed a reinsertion when tenodesis was planned, code what was actually done. Add a clinical note explaining the intraoperative finding.
Recording the pre-operative plan alongside that decision protects against a denial that challenges the code change. Practices keeping consent and assessment in digital intake records can link pre-operative forms to post-operative notes in one file, with no manual retrieval.
Related CPT codes in the 24300 series
CPT code 24340 belongs to a cluster of elbow repair and reconstruction codes. Knowing the neighbors helps you confirm code selection and spot valid combinations when several elbow procedures happen in one session. Soft-tissue codes for the same region, such as CPT 24076, can appear on the same operative claim.
When several codes from this series are billed together, review the NCCI edits to confirm whether -51 or -59 is required. Automated workflow tools can flag multi-procedure encounters for coder review before submission, which catches unbundling risk upstream of the payer.
Billing guidelines and common coding errors for CPT code 24340
The separate procedure designation is the biggest compliance issue attached to this code. Under AMA CPT guidelines, a separate procedure should not be reported on its own. That holds when it forms part of a larger procedure at the same session and site.
The rule governs which codes you may report together, rather than the amount you get paid. Billing 24340 alongside a more comprehensive elbow reconstruction code, without documentation and modifier support, is unbundling. That is an OIG enforcement priority.
Three scenarios let you bill CPT code 24340 alongside other codes:
- Different anatomical site: Tenodesis at the elbow billed alongside a shoulder or wrist procedure in the same session, supported by -59 or an XS modifier
- Different operative session: The tenodesis was performed at a distinctly different time from the companion procedure, with separate operative notes
- Distinct independent indication: The tenodesis addresses a condition unrelated to the primary procedure, with separate pre-operative diagnosis codes for each
Documentation requirements for CPT 24340
A defensible 24340 claim rests on what the operative note actually says. These elements belong in the record before the claim goes out:
- Pre-operative diagnosis: A specific ICD-10-CM code, backed by imaging, physical examination findings, and records of failed conservative treatment
- Procedure description: The technique used, whether that is suture anchor fixation, an interference screw, or a bone tunnel, plus the anatomical fixation site
- Tendon integrity status: Confirmation that the tendon was intact or partially torn at surgery. This separates the case from a complete rupture, which is coded 24342
- Separate procedure justification: Where 24340 is billed with other codes, a statement of why the tenodesis was a distinct service. Name the separate indication or site
- Implant or fixation device used: The manufacturer, product name, and quantity of any anchor or device deployed. These may trigger separate HCPCS supply codes
- Post-operative plan: The rehabilitation timeline and follow-up instructions, which demonstrate procedural completion and support the global period calculation
AI-assisted documentation lets surgeons structure the operative note during or straight after the procedure. The biller then works from the same detail the surgeon recorded, which removes the re-keying step where transcription errors creep in. Our guide to medical documentation covers form design, compliance, and workflow for surgical specialties.
Pro Tip
Before submitting any CPT 24340 claim that carries modifier -59, pull the NCCI edit pair table for 24340 and the companion code. Confirm the Column 1 and Column 2 relationship, then check whether the modifier is permitted at all (0 = not allowed, 1 = allowed with documentation). A -59 applied to an edit pair that does not permit it will still deny, however good your documentation is.
How Pabau supports orthopedic billing for CPT code 24340
Knowing the right code is half the job. The rest sits in the handoff between the operative note and the billing encounter, which is where orthopedic and surgical practices lose time.
In Pabau, billers attach CPT codes, ICD-10 codes, and modifier selections to the surgical encounter itself. The operative note stays open in the same patient record. That removes the step of pulling codes out of a separate document and typing them into a billing system.
The same workflow applies in physical rehabilitation billing, where the clinical record and the claim sit side by side. Fewer modifier omissions and code mismatches means less rework for the team chasing them.
Pabau’s built-in reporting then shows CPT frequency by provider, denial rates by code, and reimbursement trends across your payer mix. A practice billing 24340 alongside companion codes can run a denial report by code pair.
That report names the combinations triggering NCCI rejections. You can then fix the documentation workflow instead of waiting for the pattern to surface in manual claim review.
Streamline your orthopedic billing workflow
Pabau connects surgical documentation to claim generation in one platform. Link CPT codes, modifiers, and ICD-10 diagnosis codes straight from the operative note to the submitted claim, so your team spends less time correcting rejections.
Conclusion
CPT code 24340 is narrow in clinical scope and demanding in documentation. The separate procedure designation, the 24340 versus 24342 distinction, and the NCCI modifier rules are where well-intentioned claims go wrong.
Get those three right in the operative note, before the claim is generated. That is the difference between a clean first-pass submission and a denial cycle that costs more in rework than the procedure pays.
The practical move is to fix the record at the point of care, not at the point of appeal. If your billing team handles 24340 inside complex multi-procedure encounters, book a demo to see how Pabau connects surgical documentation to the claim.
Continue your research
Coding another upper-limb repair? CPT code 23462 covers reimbursement, RVUs, and modifiers for shoulder capsulorrhaphy claims.
Billing fixation alongside a soft tissue repair? CPT code 20690 explains how uniplane external fixation is reported and documented.
Need the sequela code for a shoulder dislocation? ICD-10 code S43.121S sets out the documentation for right AC joint dislocation follow-up.
Documenting the exam that led to surgery? Neer’s test shows how to perform the shoulder impingement test and interpret the result.
Tracking recovery after an upper-limb repair? Functional status questionnaire gives you a ready-made form for measuring post-operative function.
Frequently asked questions
What is CPT code 24340?
CPT code 24340 is a surgical procedure code for tenodesis of the biceps tendon at the elbow, performed as a separate procedure. It is classified under the AMA CPT musculoskeletal system chapter, specifically the repair, revision, and reconstruction subsection for the humerus and elbow. The code is used when the biceps tendon is stabilized at the elbow without full reattachment of a ruptured end.
What is the difference between CPT 24340 and CPT 24342?
CPT 24340 covers tenodesis, where the biceps tendon is intact or partially torn and is anchored to bone or tissue for stabilization. CPT 24342 covers reinsertion of a completely ruptured biceps or triceps tendon back to its bony insertion point. The key distinction is tendon continuity: if the tendon has not fully separated from its insertion, use 24340. If there is a complete rupture with proximal retraction requiring reattachment to the radial tuberosity, use 24342.
What modifiers apply to CPT 24340?
Laterality modifiers -RT (right) and -LT (left) are always required. Modifier -51 applies when CPT 24340 is the secondary procedure in a multi-procedure claim. Modifier -59 applies when an NCCI bundling edit would otherwise group 24340 with another code. Use it only where the procedures are genuinely distinct by site, session, or indication. Modifier -80 applies when an assistant surgeon participates. Verify current NCCI edit pairs before applying -59, as incorrect use is an audit trigger.
What is the Medicare reimbursement rate for CPT 24340?
Medicare reimbursement for CPT 24340 comes from Physician Fee Schedule RVU values multiplied by the annual conversion factor. The geographic practice cost index then adjusts that figure for your locality. Non-facility rates (office-based procedures) are higher than facility rates (hospital or ASC). Exact dollar amounts change with each CMS Physician Fee Schedule update. Use the CMS PFS lookup tool or FastRVU for current-year locality-adjusted rates.
When is CPT 24340 billed as a separate procedure?
The “separate procedure” designation means CPT 24340 should not be billed when it forms an integral part of a more comprehensive elbow procedure. That applies at the same session and the same anatomical site. It can be billed on its own when it is the only elbow procedure performed. It can also be billed alongside other codes in three cases. The companion procedure sits at a different site, happened at a different time, or addresses a separately documented indication. Modifier -59 or an X-modifier must support the claim.
What are the RVU values for CPT 24340?
RVU values for CPT 24340 have three components. Work RVU reflects physician time and skill. Practice expense RVU reflects overhead, which differs between facility and non-facility settings. Malpractice RVU covers liability cost. The total RVU is the sum of all three, multiplied by the CMS conversion factor and adjusted for your locality. CMS updates these values annually in the Physician Fee Schedule final rule. Use the FastRVU lookup tool or the CMS PFS search for current-year values in your MAC locality.
