CPT 24330: Elbow Flexor Muscle Transfer to Increase Flexion Strength
CPT code 24330 denotes a surgical elbow flexor transfer: relocating the flexor muscle group from the medial humeral condyle to a higher humeral insertion to improve elbow flexion strength. This reconstructive procedure is clinically significant for patients with lost or weakened elbow flexion from nerve injury, muscle loss, or chronic dysfunction, and it has implications for surgical care patterns, facility use, and payer authorization processes nationwide. Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, typical sites of service, and context for where this procedure fits in musculoskeletal and peripheral nerve reconstruction care. The publication summarizes common billing considerations, prevalent modifiers in billing practice, and gaps where specific taxonomy or diagnosis mapping is not provided. It highlights benchmarks and policy-relevant elements such as facility setting, potential authorization pathways, and national payer coverage patterns where available. Data not available in the input are noted explicitly; the report focuses on clarifying the clinical intent of the code, typical billing environment, and the payer landscape that providers and billing teams commonly navigate when coding for upper-extremity reconstructive surgeries.
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Billing Code Overview
CPT code 24330 describes a surgical procedure to increase elbow flexion strength by transferring the group of flexor muscles from the medial condyle of the humerus to a more proximal point on the humeral shaft. This operative technique is directed at restoring or augmenting active elbow flexion when native muscle-tendon function is compromised.
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Service type: Surgical, upper extremity reconstructive procedure
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Typical site of service: Hospital operating room or ambulatory surgical center
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 34-year-old right-hand–dominant patient presents with persistent weakness of elbow flexion following a traumatic mid-humeral nerve injury sustained 10 months prior. Conservative management including physical therapy and nerve recovery surveillance has not yielded functional improvement. On exam the biceps and brachialis show diminished strength (MRC grade 2–3) with preserved passive range of motion and a stable shoulder and wrist. The orthopedic surgeon recommends a muscle-tendon transfer to restore active elbow flexion.
The procedure is performed in an outpatient hospital or ambulatory surgery center setting under regional block with sedation or general anesthesia. The operative workflow includes preoperative localization and marking, exposure of the medial distal humeral flexor origin, detachment of the flexor muscle group from the medial condyle, mobilization, and reattachment to a more proximal humeral surface to improve the lever arm for elbow flexion. Intraoperative neurovascular protection and hemostasis are documented. Postoperative care includes immobilization in a protective brace or sling, pain control, and referral to supervised rehabilitation with progressive range-of-motion and strengthening protocols. Follow-up visits document wound healing, neurovascular status, and incremental gains in flexion strength.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified — typically not used in standard CMS modifier sets | Data not available in the input. |
| 11 | Normal, uncomplicated procedure | Apply when the procedure is performed without unusual events or complications.
| 22 | Increased procedural services | Use when work, time, or effort is substantially greater than typical for 24330.
| 23 | Unusual anesthesia | Use when general anesthesia is required for a procedure usually performed with regional or local anesthesia.
| 26 | Professional component | Use only when reporting separately billable physician professional component distinct from technical facility services (rare for this CPT).
| 50 | Bilateral procedure | Use when identical procedure is performed on both upper extremities during the same operative session.
| 52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned.
| 53 | Discontinued procedure | Use when the procedure was terminated due to extenuating circumstances before completion.
| 59 | Distinct procedural service | Use when a separately identifiable service is performed on the same day that is not normally reported with 24330.
| 62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct parts of the procedure.
| 63 | Procedure performed on infants less than 4 kg | Use per payer policy when applicable to neonatal patients.
| 66 | Surgical team | Use when a surgical team approach is documented for complex reconstructions involving multiple specialists.
| 78 | Return to the operating room for a related procedure during the global period | Use when an immediate postoperative complication requires a return to the OR.
| 80 | Assistant surgeon | Use when an assistant surgeon other than a co-surgeon performs part of the procedure.
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for Part B claims | Use when an APP performs services incident to physician care per payer rules.
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207L00000X | Orthopedic Surgery | Primary specialty performing upper-extremity tendon/muscle transfers. |
| 207X00000X | Hand Surgery | Subspecialists who commonly perform complex elbow/forearm reconstructions. |
| 208000000X | Physical Medicine & Rehabilitation | Manages pre- and postoperative rehabilitation and functional assessment. |
| 208600000X | Physical Therapy | Provides postoperative supervised strengthening and range-of-motion therapy. |
| 208800000X | Occupational Therapy | Focuses on activities of daily living and functional recovery of the affected limb. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M62.81 | Muscle weakness (generalized) | Documents focal loss of elbow flexion strength guiding need for transfer. |
S54.111A | Strain of muscle(s) and tendon of right forearm, initial encounter | Represents acute traumatic injury that may lead to persistent functional deficit requiring transfer. |
S44.311A | Injury of musculature of upper arm, right arm, initial encounter | Reflects direct muscle injury to flexor group prompting reconstructive transfer. |
G56.0 | Carpal tunnel syndrome | May coexist but not causative; listed when nerve compression contributes to motor deficit. |
M25.641 | Pain in right elbow | Symptom code commonly reported with functional impairment and preoperative assessment. |
S64.111A | Injury of tendon of unspecified finger at forearm level, right arm, initial encounter | Represents concomitant tendon injuries that may alter surgical planning. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
24330 | Transfer of flexor group of muscles from medial condyle of humerus to increase elbow flexion strength | Primary procedure to improve elbow flexion strength by altering muscle insertion. |
| 24358 | Tendon transfer, flexor-pronator group to restore function (not otherwise specified) | May be used for alternative or adjunctive tendon transfers addressing flexion or pronation deficits.
| 24075 | Exploration, neurovascular bundle or nerve (upper arm) | Performed when concomitant nerve exploration or neurolysis is required during reconstruction.
| 20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder) | May be used preoperatively for diagnostic or therapeutic injections to optimize motion prior to transfer.
| 25260 | Repair, flexor tendon; forearm and wrist, primary or secondary | Performed when concomitant tendon repair is necessary in the distal forearm or wrist during functional reconstruction.
| 15734 | Muscle, myocutaneous, or fascial flap; small (e.g., for coverage) | Used when soft-tissue coverage of the surgical site is required in complex cases.