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    v1.0.30
    OpenPayerBilling CodesLimb Lengthening ProcedureCPT cpt-0594t-humerus-intramedullary-lengthening-surgery
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    CPT 0594T: Humerus Lengthening with Intramedullary Distractable Nail

    CPT code 0594T describes a humeral lengthening procedure in which the surgeon performs an osteotomy of the humerus, inserts specially designed intramedullary nails into the two bone segments, and uses an external controller to distract (extend) the implant over time to promote new bone formation and progressive lengthening; the service includes intraoperative and follow-up imaging for alignment assessment and device management. This is an orthopaedic surgical implant procedure typically performed in an operating room or ambulatory surgical center with pre- and post-procedure imaging and device adjustment visits as part of the episode of care.

    For related coverage guidance, see recent payer policy updates: Implants for Joint Pain, Orthopedic Applications of Stem Cell Therapy, Bone Lengthening (Distraction Osteogenesis).

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    Clinical & Coding Specifications

    Clinical Context

    A 17-year-old adolescent with a congenital limb-length discrepancy of the humerus undergoes humeral lengthening using an internal, motorized, intramedullary nail (CPT 0594T). Preoperative evaluation includes history and physical, radiographic planning (standing and comparative upper-extremity radiographs, CT or ultrasound if indicated), and surgical consent. In the operating room under general anesthesia, the orthopedic surgeon performs a controlled osteotomy of the humerus, inserts the telescoping intramedullary device, and confirms alignment and fixation with intraoperative fluoroscopy. Postoperative care includes inpatient recovery or ambulatory observation depending on stability, serial outpatient clinic visits for device activation (external controller adjustments), regular radiographic assessment of regenerate bone formation and alignment, and device management including potential minor adjustments or imaging. Typical lengthening occurs over weeks to months with scheduled distraction sessions and graduated rehabilitation (physical and occupational therapy) to maintain joint range of motion and neurovascular monitoring. Indications include congenital shortening, post-traumatic shortening, or skeletal dysplasia affecting humeral length and function. Typical site of service is an ambulatory surgical center or hospital outpatient department for the index procedure, with follow-up visits in clinic and periodic imaging in radiology.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    20690Removal of implant; deep (e.g., buried intramedullary device), requiring operative incisionMay be performed after consolidation to remove the intramedullary lengthening device.
    77002Fluoroscopic guidance for needle placement (single procedure); < specific fluoroscopy codes vary >Intraoperative fluoroscopy and alignment confirmation are integral to 0594T (use appropriate fluoroscopy guidance CPT as documented).
    99024Postoperative follow-up visit, normally included in global period (sometimes used by payers for unrelated visits)Routine postoperative follow-up and device management visits after 0594T are typically part of the global period; use only per payer policy for unrelated services.
    20660Closed treatment of displaced extra-articular fracture or epiphyseal separation, with manipulation; with or without anesthesiaRelated as a potential prior procedure for traumatic indications; may occur before or instead of lengthening in acute fractures.
    21076Distraction osteogenesis procedure, mandibular (separate example of distraction technique)Conceptually related as a distraction osteogenesis code in another anatomic region; not billed with 0594T but useful for coding parallels and payer discussions.

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207X00000X
    207L00000X
    208U00000X
    2080P0206X
    207K00000X
    207KA0200X
    133VN1005X
    172A00000X

    Related ICD-10-CM Codes

    19 rows

    ICD-10-CM CodeDescription
    G54.6Phantom limb syndrome with pain
    M25.211Flail joint, right shoulder
    M25.221Flail joint, right elbow
    M25.241Flail joint, right hand
    M80.071AAge-related osteoporosis with current pathological fracture, right ankle and foot, initial encounter for fracture
    M81.0Age-related osteoporosis without current pathological fracture
    M84.351AStress fracture, right femur, initial encounter for fracture
    M84.352AStress fracture, left femur, initial encounter for fracture
    M85.811Other specified disorders of bone density and structure, right shoulder
    M85.819Other specified disorders of bone density and structure, unspecified shoulder

    Showing 1–10 of 19

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 2

    10 rows

    PolicyPayerEffective Date
    Implants for Joint PainBlue Cross Blue Shield - Rhode Island2027-03-01
    Orthopedic Applications of Stem Cell TherapyBlue Cross Blue Shield - Rhode Island2027-01-01
    Bone Lengthening (Distraction Osteogenesis)Blue Cross Blue Shield - North Dakota2027-01-01
    Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Membersuniverahealthcare2027-01-01
    Sacroiliac Joint Fusion for the Treatment of Adult Low-Back Pain Medical PolicyHealth-New-England2026-12-01
    Bone Grafts and Stabilization Devices for Spinal Defects - Medical PolicyHealth-New-England2026-12-01
    Implantable Shock Absorbers for Treatment of Knee Osteoarthritisblue cross blue shield - louisiana2026-12-01
    Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policybcbsvermont2026-12-01
    Cartilage Implants for Joint Painpremerabluecrossofwashington2026-11-06
    Cartilage Implants for Joint Painpremerabluecrossofwashington2026-11-06

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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