Summary & Overview
CPT 24102: Open Elbow Synovectomy
CPT code 24102 represents an open elbow synovectomy: a surgical incision into the elbow joint to excise inflamed synovium. The procedure is clinically important for patients with inflammatory joint disease—most commonly rheumatoid arthritis—where removal of synovial tissue aims to reduce pain, inflammation, and progressive joint damage. Nationally, this code captures inpatient or outpatient surgical services performed in operating rooms and ambulatory surgical centers.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The summary provides a clinical and billing context for the code and highlights typical sites of service. Readers will find benchmarks for utilization and reimbursement patterns where available, relevant clinical indications and coding context, and any recent policy or coverage developments that affect surgical synovectomy for the elbow. The report is intended to support revenue cycle, clinical coding, and policy teams by clarifying the code’s clinical purpose, expected care setting, and how major payers approach coverage and reimbursement. Data not available in the input is noted where details were not provided.
Billing Code Overview
CPT code 24102 describes an open surgical procedure in which the provider makes an incision at the elbow joint and performs an elbow synovectomy to remove inflamed synovial tissue. This procedure is typically performed to relieve pain, reduce inflammation, and improve joint function in patients with conditions such as rheumatoid arthritis or other inflammatory synovitis.
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Service type: Surgical; open elbow synovectomy
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Typical site of service: Operating room or ambulatory surgical center for open elbow joint surgery
Clinical & Coding Specifications
Clinical Context
A 58-year-old female with long-standing seropositive rheumatoid arthritis presents with progressive elbow pain, stiffness, swelling, and decreased range of motion despite optimized medical therapy (disease-modifying antirheumatic drugs and corticosteroid injections). Physical exam demonstrates a warm, boggy elbow joint with crepitus and limited flexion/extension interfering with activities of daily living. Imaging (radiographs and MRI) shows synovial hypertrophy with joint effusion and early erosive changes without acute fracture. The orthopedic surgeon schedules an open elbow synovectomy under general anesthesia. Intraoperatively, a standard posterior or lateral incision is used to access the joint; hypertrophic synovium is excised to reduce inflammatory burden and improve motion. Typical perioperative workflow includes preoperative assessment by anesthesia, appropriate antibiotic prophylaxis, regional block or multimodal analgesia, intraoperative synovial removal, hemostasis, and placement of a drain if indicated. Postoperative care includes pain control, immobilization for a short period, early range of motion with supervised physical therapy, and follow-up for wound check and functional assessment. Typical site of service is an outpatient ambulatory surgery center or inpatient hospital operating room depending on comorbidities and expected complexity. Service type: surgical, open elbow synovectomy for inflammatory joint disease or other synovial pathology.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side |