Summary & Overview
CPT 24343: Elbow Collateral Ligament Repair, Direct Repair Without Graft
CPT code 24343 denotes surgical repair of a damaged collateral ligament at the elbow—performed at the ligament end or mid-substance without use of a graft. This procedure is a focused orthopedic soft-tissue repair commonly performed after acute traumatic injury or symptomatic instability. Nationally, it matters because it represents a discrete operative intervention with implications for surgical resource use, post-operative rehabilitation, and payer coverage policies across commercial and public plans.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for CPT code 24343, typical sites of service, and the types of surgical services it represents. The publication summarizes common billing practices and benchmarking considerations, highlights relevant policy and coverage features that frequently affect authorization and reimbursement, and outlines areas where coding specificity influences payment (e.g., repair versus reconstruction with graft).
This national-level brief equips clinicians, coding professionals, and payers with a clear understanding of the code’s clinical meaning, typical care settings, and the operational considerations that commonly arise when CPT code 24343 is billed.
Billing Code Overview
CPT code 24343 describes a surgical procedure to repair a damaged collateral ligament of the elbow, performed at the elbow end or mid-substance without use of a graft. This is an orthopedic surgical service focused on direct repair of the native ligament tissue.
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Service type: Surgical repair (orthopedic soft-tissue procedure)
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Typical site of service: Hospital inpatient or outpatient surgical setting, ambulatory surgery center, or specialized orthopedic surgical suite
Clinical & Coding Specifications
Clinical Context
A 34-year-old right-hand-dominant recreational tennis player presents with persistent lateral elbow pain and instability after sustaining a twisting injury during a fall on an outstretched hand. Conservative care (rest, physical therapy, bracing, and NSAIDs) failed over 6 months. Imaging with MRI demonstrates a partial-to-complete tear of the lateral (or medial) collateral ligament of the elbow without substantial tissue loss. The orthopedic surgeon schedules an open repair of the collateral ligament at the elbow (no graft) under general anesthesia with regional block. The typical workflow includes preoperative evaluation, informed consent, surgical repair of the damaged ligament by direct suture or anchor fixation, intraoperative neurovascular monitoring as indicated, wound closure, postoperative immobilization in a splint or hinged brace, and a staged rehabilitation protocol with early protected motion followed by progressive strengthening.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician’s professional services separate from technical facility charges (rare for this surgical procedure). |
50 | Bilateral procedure |