Summary & Overview
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.
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. |