CPT 24305: Upper Arm/Elbow Tendon Lengthening for Contracture Release
CPT code 24305 denotes a surgical tendon lengthening procedure performed on the upper arm or elbow to release a contracture. This procedure addresses limited range of motion caused by shortened tendons and is performed in operative settings. Nationally, it is relevant for orthopedic and reconstructive surgeons managing contractures from trauma, neuromuscular conditions, or post-surgical fibrosis.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, typical sites of service, and payer coverage considerations for CPT code 24305. The publication outlines common billing modifiers and related administrative elements where available, and highlights areas where policy updates or payer-specific coverage rules may influence claim adjudication.
This summary equips billing managers, surgical providers, and policy analysts with concise information about the clinical intent of CPT code 24305, operational settings in which the service is delivered, and the payer landscape affecting reimbursement and authorization processes. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 24305 describes a surgical procedure to increase the length of a tendon of the upper arm or elbow to release a contracture. This procedure is categorized as a surgical tendon lengthening for the upper extremity.
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Service type: Surgical tendon lengthening / contracture release
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Typical site of service: Hospital outpatient department or ambulatory surgical center, depending on clinical complexity and facility capabilities.
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Clinical & Coding Specifications
Clinical Context
A 46-year-old patient presents with a progressive flexion contracture of the elbow caused by post-traumatic scarring and muscle/tendon shortening, limiting extension and impairing activities of daily living and work duties. Conservative measures including physical therapy, splinting, and serial casting have been attempted for several months without adequate improvement. Imaging and clinical exam localize the contracture to a shortened biceps or brachialis tendon complex. The surgical team schedules a tendon lengthening procedure to release the contracture and restore functional elbow extension.
The clinical workflow includes preoperative evaluation with focused history and physical, documentation of failed conservative care and functional limitations, informed consent, preoperative anesthesia assessment, operative tendon lengthening under regional or general anesthesia, intraoperative assessment of range of motion with staged lengthening as needed, hemostasis and wound closure, and postoperative immobilization followed by early supervised rehabilitation. Typical site of service is an outpatient ambulatory surgery center or hospital operating room depending on patient comorbidities and anesthesia requirements.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician’s professional portion separate from facility technical services for related diagnostic procedures or interpretations. |
50 | Bilateral procedure | Use when identical tendon lengthening is performed on both upper extremities during the same operative session. |
51 | Multiple procedures | Use when multiple distinct surgical procedures are performed during the same operative session in addition to the tendon lengthening. |
52 | Reduced services | Use when the tendon lengthening is started but intentionally not completed or performed at a reduced level. |
53 | Discontinued procedure | Use when the procedure is terminated due to extenuating circumstances after initiation. |
59 | Distinct procedural service | Use when separate and distinct procedures are performed at the same operative session that are not normally bundled. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct operative portions of the tendon lengthening. |
66 | Surgical team | Use when multiple surgical specialists operate as a team for a complex lengthening/contracture release. |
78 | Return to OR for related procedure during global period | Use when an unplanned return to the operating room for a complication related to the tendon lengthening occurs during the global period. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated surgical procedure is performed during the global period. |
LT | Left side | Use to indicate the procedure was performed on the left upper extremity. |
RT | Right side | Use to indicate the procedure was performed on the right upper extremity. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals | Use when the surgeon documents anesthetic management requiring this anesthesia modifier for concurrent cases (applies to anesthesia billing). |
ET | Eligible trainee billing (for teaching physicians) | Use when a teaching physician documents and reports services furnished with trainee involvement per payer rules. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207P00000X | Orthopaedic Surgery | Primary specialty performing upper-extremity tendon lengthening and elbow contracture releases. |
| 207RH0000X | Hand Surgery | Specialists managing complex tendon and soft-tissue procedures of the distal upper extremity including elbow and biceps contractures. |
| 207L00000X | Physical Medicine & Rehabilitation | Often involved in preoperative functional assessment and postoperative rehabilitation coordination. |
| 208000000X | General Surgery | May perform upper-extremity tendon procedures in some practice settings. |
| 207K00000X | Plastic Surgery | Performs soft-tissue reconstruction and tendon lengthening for contracture release when soft-tissue coverage concerns exist. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M24.311 | Contracture, right elbow | Direct indication for tendon lengthening to release a fixed flexion or extension contracture. |
M24.312 | Contracture, left elbow | Direct indication for tendon lengthening on the left side. |
M24.319 | Contracture, unspecified elbow | Used when side unspecified; identifies elbow contracture requiring surgical release. |
M62.81 | Muscle weakness (generalized) | May accompany contracture and influences rehabilitation planning; not a primary surgical indication but relevant comorbidity. |
S46.011A | Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter | Represents traumatic tendon injury that can lead to secondary contracture involving the upper arm/elbow region. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
24305 | Tendon lengthening, upper arm or elbow, surgically increases tendon length to release contracture | Primary procedure for surgical release of elbow/upper-arm tendon contracture. |
20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee) | May be performed preoperatively for diagnostic or therapeutic joint injections when joint involvement contributes to limited motion. |
25075 | Tenolysis, elbow; open | May be performed when tendon adhesions require release in addition to or instead of lengthening. |
25240 | Tendon transfer or graft, flexor or extensor of forearm and wrist; primary repair | Performed when primary tendon repair or transfer is needed in the same operative session to restore function. |
24300 | Repair, tendon, biceps or triceps (upper arm), primary | Related when tendon repair is indicated in the operative field or performed concurrently. |
29827 | Arthroscopy, elbow, surgical; debridement/loose body removal | Performed when intra-articular pathology contributes to limited range of motion and is addressed at the same operative setting. |