Summary & Overview
CPT 24340: Distal Biceps Tendon Repair
CPT code 24340 denotes surgical repair of a ruptured distal biceps tendon to restore elbow function. This procedure is clinically important because distal biceps ruptures produce significant loss of flexion and supination strength; timely surgical repair can improve functional outcomes and reduce long-term disability. Nationally, this code is relevant across commercial and public payers due to its association with orthopedic trauma and elective reconstructive surgery.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical indications, typical sites of service (hospital outpatient departments and ambulatory surgery centers), and the expected service type (surgical tendon repair). The publication also summarizes common billing considerations and related service lines where data are available, and provides benchmarks and policy context where relevant.
The report is intended for clinicians, billing professionals, and policy analysts seeking a concise reference for CPT code 24340, its clinical role, and payer coverage patterns. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 24340 describes a surgical procedure to repair a rupture of the distal biceps tendon with the clinical goal of restoring elbow function, strength, and forearm supination. This procedure is a repair of a tendon rupture performed by an orthopedic or hand surgery provider.
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Service type: Surgical repair of distal biceps tendon rupture
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Typical site of service: Hospital outpatient department or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 45-year-old right-hand-dominant male presents with acute anterior elbow pain, a palpable gap in the antecubital fossa, and weakness with forearm supination after lifting a heavy object. Physical exam demonstrates a positive hook test consistent with distal biceps tendon rupture. Imaging with MRI confirms a full-thickness rupture of the distal biceps tendon with proximal retraction. The typical clinical workflow includes preoperative evaluation and informed consent, perioperative anesthesia clearance, surgical repair of the distal biceps tendon (CPT 24340) in an ambulatory surgery center or hospital outpatient operating room, intraoperative use of fixation (suture anchors or cortical buttons), immediate postoperative immobilization and pain control, and coordinated outpatient physical therapy for progressive range of motion and strengthening. Typical sites of service are an ambulatory surgery center (ASC) or hospital outpatient operating room. Common patients are adults aged 30–60 after traumatic eccentric loading of the forearm; smokers, anabolic steroid users, and those with prior tendon degeneration are at higher risk.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when an unrelated or significant E/M is performed on the same day as CPT 24340 (Note: was not in the provided modifier list; adherence to input modifiers required.) |