Summary & Overview

CPT 24301: Tendon/Muscle Transfer, Upper Arm or Elbow

Headline: CPT code 24301: Tendon/Muscle Transfer to Restore Upper-Arm or Elbow Function

Lead: CPT code 24301 describes a surgical tendon or muscle transfer in which tendons or muscles from the upper arm or elbow are moved to restore full function of an affected region while preserving function at the graft harvest site. The procedure is clinically significant for patients with loss of function due to trauma, nerve injury, or other musculoskeletal disorders and has implications for surgical resource use and postoperative rehabilitation across the health system.

This national summary covers payment, clinical context, and coding practice for major payers. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the procedure and expected sites of service, plus an overview of common modifiers used with surgical procedures when available. The report provides clinical context about why tendon/muscle transfers are performed, typical care settings (hospital outpatient departments, ambulatory surgery centers, and inpatient surgical units), and implications for coverage and claims processing.

What readers will learn: benchmarks and payer coverage patterns where available; procedural context and typical sites of service; common coding considerations and data availability notes. Data not available in the input is explicitly identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare24301CPTtendon transfermuscle transferupper arm surgeryelbow surgeryorthopedic surgeryambulatory surgeryhospital outpatient

Billing Code Overview

CPT code 24301 describes a tendon or muscle transfer procedure in which tendons or muscles from the upper arm or elbow are repositioned to restore full function of an affected area while preserving function at the graft harvest site.

Service type: Surgical tendon/muscle transfer
Typical site of service: Hospital outpatient department or ambulatory surgery center; may also occur in inpatient surgical settings depending on clinical need and patient status.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with significant loss of elbow or upper-arm function due to traumatic tendon rupture, brachial plexus injury, or chronic paralysis where tendon transfer can restore active motion. The patient presents to a hand/upper-extremity orthopedic surgeon or plastic surgeon after failed conservative management (therapy, orthoses, or nerve repair) and persistent functional deficits such as inability to extend the wrist, fingers, or elbow, or loss of forearm supination/pronation. Preoperative evaluation includes detailed motor and sensory exam, electromyography or nerve conduction studies as indicated, imaging to assess tendon and muscle integrity, and discussion of expected functional gains and donor-site limitations.

The clinical workflow: the surgeon documents indications, identifies suitable donor tendons/muscles in the upper arm or around the elbow, and plans the transfer to restore a specific lost action while preserving donor-site function. On the day of service the procedure is performed in an operating room or ambulatory surgery center under regional block or general anesthesia; intraoperative testing confirms tension and excursion. Postoperative care includes splinting, wound checks, and a structured hand therapy program over weeks to months for tendon gliding, strengthening, and motor re-education to achieve optimal functional recovery.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the surgeon's professional component is billed separately from the technical facility component.
`50`	Bilateral procedure	Use when identical tendon transfers are performed on both upper extremities during the same operative session.
`51`	Multiple procedures	Use when additional unrelated surgical procedures are performed at the same session in addition to the tendon transfer.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when the procedure is started but discontinued due to patient safety or intraoperative findings.
`59`	Distinct procedural service	Use to indicate a separate and distinct procedure performed at a different anatomic site or session when bundling edits might apply.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons on different parts of the procedure requiring distinct surgical skills.
`66`	Surgical team	Use when a surgical team approach is used for complex reconstructions necessitating team billing.
`78`	Return to the operating room for a related procedure during the postoperative period	Use when a related unplanned return to the OR for treatment of a complication is required in the global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.
`22`	Increased procedural services	Use when the surgery required substantially greater effort, time, or complexity than usual.
`58`	Staged or related procedure during the postoperative period	Use when a planned second-stage tendon or flap procedure is performed during the global period.
`76`	Repeat procedure by same physician	Use when the exact procedure is repeated subsequent to the initial service by the same physician.
`RT` / `LT`	Right/Left side	Use to identify the laterality of the operated upper extremity.

Taxonomy Code	Specialty	Notes
208U00000X	Orthopaedic Surgery	Orthopedic hand and upper-extremity surgeons commonly perform tendon transfer surgeries.
2084P0800X	Plastic Surgery	Plastic and reconstructive surgeons perform complex tendon and muscle transfers for functional restoration.
207W00000X	Physical Medicine & Rehabilitation	Physiatrists coordinate pre- and post-operative rehab and may perform perioperative management.
213E00000X	Hand Surgery	Subspecialty hand surgeons (orthopedic or plastic) focus specifically on tendon transfers and reanimation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M66.4`	Spontaneous rupture of other tendons	Indicates tendon rupture that may require transfer when primary repair is not viable.
`S46.021A`	Strain of muscle, fascia and tendon of left upper arm, initial encounter	Traumatic muscle/tendon injury leading to functional loss addressed by tendon transfer.
`G54.4`	Brachial plexus disorders	Nerve injury causing paralysis where tendon transfer can restore function when nerve repair is incomplete or delayed.
`M25.3`	Other instability of joint	Chronic joint instability limiting active control that may be addressed by tendon transfers to improve function.
`M62.81`	Muscle weakness (generalized)	Focal muscle weakness from neurologic injury treated by tendon/muscle transfer to restore movement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`25210`	Tendon transfer; flexor to extensor of hand or wrist	Performed when wrist/finger extension is restored by transferring a flexor tendon—an alternative or adjunct to upper-arm transfers when indicated.
`25300`	Tendon transfer, elbow, flexor to extensor or extensor to flexor, single tendon	Codes for other elbow-level tendon transfers that may be performed for isolated deficits or in combination with `24301` for complex reconstructions.
`20690`	Application of external fixation system (separate procedure)	May be used pre- or post-transfer if stabilization of bony alignment or temporary fixation is required.
`29515`	Application of long-arm cast, shoulder to hand	Used for postoperative immobilization following an upper-arm or elbow tendon transfer.
`97110`	Therapeutic exercises to develop strength and endurance, neuromuscular re-education	Common postoperative therapy CPT code billed for rehabilitation after tendon transfer to retrain motor patterns and restore function.