Summary & Overview

CPT 24115: Humerus Bone Cyst/Tumor Excision with Autograft

CPT code 24115 represents surgical excision of a benign bone lesion or cyst from the humerus with removal of the involved bone and filling of the defect using autologous graft material. This procedure is a definitive orthopedic surgical treatment for symptomatic or structurally compromising benign humeral lesions and is clinically important because it addresses pain, fracture risk, and functional impairment of the upper extremity. Nationally, the procedure occurs in hospital operating rooms and ambulatory surgical centers and is typically performed by orthopedic surgeons specializing in upper extremity or musculoskeletal oncology procedures.

Key payers in coverage discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when this surgery is used, typical sites of service, and the operational and coding considerations relevant to inpatient and outpatient settings. The publication also outlines common billing modifiers (listed separately) and notes when additional documentation may be expected by payers. Data not available in the input are explicitly identified where applicable. The report is intended to inform coding professionals, revenue cycle staff, and clinicians about the clinical purpose of CPT code 24115, the payer landscape, and the types of benchmarks and policy items that affect authorization and reimbursement nationally.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 24115orthopedic surgeryhumerusbone cystbone graftingautograftupper extremity surgeryoperative procedure

Billing Code Overview

CPT code 24115 describes a surgical procedure in which the provider excises a bone cyst or benign (noncancerous) tumor from the humerus. The procedure includes removal of the portion of the humeral bone involved by the lesion and filling the resulting bone defect with autologous graft material harvested from the same patient.

Service type: Surgical excision with bone grafting (autograft)
Typical site of service: Hospital operating room or ambulatory surgical center for orthopedic surgery on the upper extremity

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult or adolescent presenting with intermittent arm pain, localized tenderness, or a pathologic fracture of the proximal or mid humerus. Imaging (radiographs, CT, or MRI) demonstrates a benign bone lesion such as a unicameral bone cyst or an enchondroma confined to the humeral diaphysis or metaphysis. The orthopedic surgeon schedules an operative procedure under general anesthesia in an ambulatory surgery center or hospital outpatient department. Intraoperatively the surgeon performs an open excision/curettage of the bone cyst or benign tumor on the humerus, removes the compromised cortical bone as needed, harvests autologous bone graft (commonly from the iliac crest), packs the humeral defect with the grafting material, and obtains hemostasis and wound closure. Specimens may be sent for pathology to confirm benign histology. Postoperative care includes pain control, immobilization (sling), activity restrictions, and radiographic follow-up to assess graft incorporation and bone healing. Typical sites of service are ambulatory surgery center (ASC) or hospital outpatient surgical suite.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or time substantially exceeds usual for the procedure due to complexity (document increased work).
`50`	Bilateral procedure	Use if both humeri are treated during the same operative session (rare for this code).
`51`	Multiple procedures	Use when additional unrelated procedures are performed at the same session (append additional procedure codes).
`52`	Reduced services	Use when the procedure is partially reduced or not completed.
`53`	Discontinued procedure	Use when procedure is terminated for patient safety before completion.
`62`	Two surgeons	Use when two surgeons with different specialties perform distinct portions of the procedure.
`76`	Repeat procedure by same physician	Data not available in the input.
`78`	Unplanned return to the operating room	Use when patient returns to OR for a related complication during the global period.
`80`	Assistant surgeon	Use when a surgical assistant contributes to the procedure (coverage/contracting rules apply).
`LT`	Left side	Use to identify the left humerus when laterality is required.
`RT`	Right side	Use to identify the right humerus when laterality is required.
`26`	Professional component	Use when billing only the physician interpretation/professional component of a service (rare for CPT `24115`).
`TC`	Technical component	Use when billing only the facility/technical component (rare for surgical procedures).
`59`	Distinct procedural service	Data not available in the input.

Taxonomy Code	Specialty	Notes
`208Z00000X`	Orthopedic Surgery	Primary specialty performing tumor/cyst excision and grafting of the humerus.
`207L00000X`	Musculoskeletal/Orthopaedic Surgery	Alternate taxonomy used for orthopedic surgeons focused on upper extremity.
`207K00000X`	Hand Surgery	Hand/upper extremity surgeons may perform proximal humerus procedures when focused on limb-sparing function.
`208000000X`	Surgical Oncology	Surgical oncologists may be involved if lesion requires oncologic evaluation or complex resection.
`363A00000X`	Physical Medicine & Rehabilitation	Manages postoperative rehabilitation and functional recovery.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M84.4X-`	Pathological fracture, humerus (use appropriate 7th character)	Pathologic fractures can result from benign bone cysts or tumors weakening the humerus and often prompt surgical curettage and grafting.
`M85.8`	Other specified disorders of bone density and structure	Captures nonneoplastic structural bone disorders that may coexist or mimic cystic lesions.
`D16.4`	Benign neoplasm of bone and articular cartilage of limb(s)	Directly describes benign bone tumors of the humerus such as enchondroma.
`M89.0`	Nontraumatic osteolysis of bone	May describe localized bone loss from cystic lesions requiring grafting.
`M85.9`	Disorder of bone density and structure, unspecified	Used when a specific diagnosis is pending but surgical management is required.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`73030`	Radiologic examination, humerus; complete, minimum of two views	Preoperative and postoperative radiographic assessment for lesion characterization and follow-up.
`20206`	Biopsy, soft tissue of head/neck (open) — placeholder: Data not available in the input.	Data not available in the input.
`20937`	Autograft for spine or other small osseous defects; morselized bone, any donor site	Used to report autologous bone grafting material harvested and implanted to fill the humeral defect when appropriate.
`27096`	Removal of bone graft (not specific to humerus) — placeholder: Data not available in the input.	Data not available in the input.
`20680`	Removal of implant; deep (e.g., plates, screws)	May be used later if hardware removal is required after healing if internal fixation was placed concurrently or subsequently.