Summary & Overview
CPT 24361: Elbow Arthroplasty, Humeral Component Replacement
CPT code 24361 represents an elbow joint arthroplasty procedure in which the arthritic end of the humerus is replaced with a prosthesis. As a major upper-extremity joint replacement, this code captures a complex operative service with implications for hospital and ambulatory surgery center resource use, perioperative care pathways, and rehabilitation planning. Nationally, elbow arthroplasty volumes are lower than hip or knee replacements but are clinically significant for patients with severe elbow arthritis, post-traumatic deformity, or failed prior surgeries.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, and payer coverage patterns. The publication summarizes benchmarks for utilization and reimbursement where available, highlights recent policy or coding clarifications affecting joint arthroplasty billing, and provides clinical coding context to support accurate claim submission. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 24361 describes an elbow joint arthroplasty procedure in which the provider replaces the arthritic end of the humerus with a prosthesis. This is an operative orthopedic procedure focused on relieving pain and restoring function in the elbow joint affected by arthritis or degenerative disease.
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Service type: Surgical arthroplasty of the elbow (humeral component replacement)
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Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 68-year-old right-hand-dominant female with long-standing, progressive elbow pain and decreased range of motion presents after failed conservative care including activity modification, NSAIDs, corticosteroid injection, and physical therapy. Imaging shows end-stage tricompartmental elbow osteoarthritis with joint space loss and osteophyte formation, and she reports significant functional impairment with activities of daily living such as dressing and grooming. The orthopaedic surgeon schedules an elective total elbow arthroplasty to replace the arthritic distal humerus and restore joint alignment and function.
Preoperative workflow includes history and physical, medical clearance (cardiac evaluation as indicated), baseline labs, and preop templating. On the day of surgery the patient undergoes regional block or general anesthesia, sterile prep and exposure of the elbow joint, resection of the arthritic distal humeral articular surface, implantation of the humeral component (with cement as indicated), trialing of polyethylene or ulnar components, assessment of range of motion and stability, and layered wound closure. Postoperative care includes inpatient or same-day PACU recovery, pain management, prophylactic antibiotics and thromboprophylaxis as indicated, early supervised range-of-motion therapy, and outpatient follow-up for wound check and progressive rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | When both elbows undergo arthroplasty during the same operative session |