Understanding CPT Code for Olecranon Bursectomy

What Is an Olecranon Bursectomy?

The olecranon bursa sits over the bony tip of the elbow and reduces friction between skin and bone. When swelling, pain, or infection persists despite conservative care (aspiration, compression, antibiotics, activity modification), surgeons may remove the bursa through an open bursectomy.

Primary CPT® Code You’ll Use

• 24105 — Excision, olecranon bursa
  Report when the operative note documents complete excision of the olecranon bursa for chronic, recurrent, or septic bursitis.

Closely Related Scenarios (Choose the Right Code)

• 23931 — Incision and drainage, upper arm or elbow area; bursa
  Use when the procedure is I&D/drainage only (no complete excision).
• Aspiration/injection of the olecranon bursa
  • 20605 — Intermediate joint/bursa without ultrasound guidance
  • 20606 — Intermediate joint/bursa with ultrasound guidance
    Note: The elbow/olecranon bursa is considered intermediate, not “major.”
• Elbow arthrotomy (joint work, not bursa)
  • 24100 — Arthrotomy, elbow; with synovial biopsy only
  • 24101 — Arthrotomy, elbow; with joint exploration, with/without biopsy, with/without removal of loose body
    These codes are intra-articular and generally not appropriate for extra-articular bursa excision.
• Arthroscopic olecranon bursectomy
  There is no specific arthroscopic CPT® code for extra-articular olecranon bursa excision. Many payers direct to 24999 — Unlisted procedure, humerus or elbow. Submit op note and a comparator code per payer policy.

ICD-10-CM Pairing (Diagnosis)

Use laterality-specific codes for olecranon bursitis:

• M70.21 — Right elbow
• M70.22 — Left elbow
• M70.20 — Unspecified elbow

Modifiers & Global Period Tips

• Global period: 24105 is commonly treated as a major (90-day) global; 23931 typically has a 10-day global. Always confirm with payer tables.
• Consider -50 (Bilateral) if both elbows are treated in the same session (payer dependent).
• Use -59/X{EPSU} or -51 when reporting distinct, separately reportable procedures that are not bundled by NCCI edits.
• -22 may be appropriate for unusually complex excisions (e.g., extensive infection or revision).
• Assistant surgeon modifiers (-80/-81/-82) per operative need and payer policy.

Documentation Checklist

Make sure the record clearly supports your code choice:

• Diagnosis and laterality (e.g., M70.21/M70.22)
• Failed conservative therapy (aspiration, antibiotics, compression, activity modification)
• Procedure specifics: complete excision vs drainage, open vs endoscopic approach, drain placement, tissue sent to pathology
• Any concurrent procedures and that they are distinct from the bursal work
• Post-op care consistent with the applicable global period

Common Coding Pitfalls

1. Confusing I&D with excision
   If the op note describes incision and drainage only, report 23931—not 24105.
2. Using major-joint injection codes for the elbow
   The olecranon bursa is intermediate: choose 20605/20606, not 20610/20611.
3. Reporting arthrotomy for bursal surgery
   24100/24101 describe intra-articular work; the olecranon bursa is extra-articular—use 24105 for excision.
4. Overlooking global periods
   Align follow-up billing with the correct global package to avoid denials.
5. Arthroscopic bursal work
   For extra-articular arthroscopic excision, many plans expect 24999 with supporting documentation and pre-auth.

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