Summary & Overview

CPT 24515: Open Fixation of Humeral Shaft Fracture

CPT code 24515 denotes open surgical fixation of a humeral shaft fracture using internal hardware such as wires, screws, and possible cerclage wiring. This operative orthopedic code is nationally relevant because fractures of the humeral shaft are common traumatic injuries that require definitive fixation to restore arm function and prevent complications. Coverage and payment for operative fixation affect hospital, ambulatory surgery center, and orthopedic practice workflows and finances across payers.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical framing of the procedure, typical sites of service, and the common procedural context for billing. The publication outlines payer coverage patterns, coding and billing considerations tied to procedure complexity, and commonly reported modifiers associated with surgical services. It also provides benchmarking context and notes on documentation elements relevant to claim adjudication.

This summary serves providers, billing professionals, and policy analysts seeking a compact reference on what CPT code 24515 represents, where it is typically performed, and what to expect from major commercial and government payers at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare24515CPTorthopedic-surgeryhumerus-fractureopen-fixationinternal-fixationtraumaambulatory-surgery-centeroperating-room

Billing Code Overview

CPT code 24515 describes an open surgical treatment of a humeral shaft fracture. The procedure involves a surgical incision over the upper arm to expose the fractured humerus, followed by internal fixation using wires and screws; a cerclage technique (encircling the bone with wire) may be employed.

Service type: Open internal fixation of humeral shaft fracture
Typical site of service: Operating room or ambulatory surgery center for orthopedic surgery

Clinical & Coding Specifications

Clinical Context

A 42-year-old male construction worker presents after a fall from a ladder with severe pain, deformity, and swelling of the mid upper arm. Radiographs demonstrate a displaced transverse fracture of the humeral shaft. Nonoperative management is considered but due to significant displacement and concern for cortical apposition, the orthopedic trauma surgeon schedules an open reduction and internal fixation. In the operating room under general anesthesia, a longitudinal incision is made over the lateral aspect of the arm, soft tissues are dissected to expose the fracture, and reduction is achieved. Fixation is performed using a combination of cortical screws and Kirschner wires with supplemental cerclage wiring as required to obtain rigid stabilization. Intraoperative fluoroscopy confirms alignment and hardware position. The surgical team documents operative details, estimated blood loss, implants used, laterality (left or right), anesthesia type, and any intraoperative complications.

Typical workflow elements include preoperative evaluation and consent, radiographic review and templating, operating room setup with fluoroscopy, open reduction and internal fixation using plates/screws and/or wires and cerclage, wound closure, postoperative radiographs, immediate recovery room monitoring, and initiation of a postoperative rehabilitation plan with follow-up imaging and clinic visits.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	Use when the procedure is performed on the left humerus.
`RT`	Right side	Use when the procedure is performed on the right humerus.
`50`	Bilateral procedure	Use if both humeral shafts are treated during the same operative session.
`62`	Two surgeons	Use when two surgeons of different specialties perform distinct portions of the procedure.
`78`	Unplanned return to OR	Use for a related return to the operating room for a complication during the global period.
`79`	Unrelated procedure or service	Use when an unrelated procedure is performed during the postoperative period.
`22`	Increased procedural services	Use when work or resources are substantially greater than typical for open humeral shaft fixation.
`52`	Reduced services	Use when the procedure is partially reduced or limited compared with the full procedure.
`76`	Repeat procedure by same physician	Use for an additional instance of fixation on the same date by the same surgeon (not in provided list; not applicable).
`59`	Distinct procedural service	Use when a separate, distinct procedure is performed at a different anatomic site or during a different encounter.
`73`	Discontinued outpatient procedure prior to anesthesia	Use when the outpatient procedure was discontinued before anesthesia was administered.
`53`	Discontinued procedure	Use when the procedure is started but discontinued due to extenuating circumstances.
`24`	Unrelated E/M during postoperative period	Use when an unrelated evaluation and management service is provided during the global period.

Taxonomy Code	Specialty	Notes
207T00000X	Orthopaedic Surgery	Primary specialty performing open reduction and internal fixation of humeral shaft fractures.
2080P0206X	General Surgery	May perform in trauma centers when orthopedics not available or for combined injuries.
208U00000X	Trauma Surgery	Manages complex polytrauma patients; may perform or coordinate definitive fixation.
225100000X	Occupational Medicine	Often provides preoperative clearance and postoperative work/activity restrictions.
207L00000X	Hand Surgery	Involvement when fracture extends into distal humerus or for distal fixation planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S42.301A`	Displaced fracture of shaft of humerus, unspecified arm, initial encounter for closed fracture	Represents a displaced humeral shaft fracture commonly requiring open reduction and internal fixation.
`S42.302A`	Displaced fracture of shaft of humerus, left arm, initial encounter for closed fracture	Specific laterality for left humeral shaft fractures treated with ORIF.
`S42.301B`	Displaced fracture of shaft of humerus, unspecified arm, initial encounter for open fracture	Used when the fracture is open and requires surgical debridement and fixation.
`S42.203A`	Undisplaced fracture of shaft of humerus, unspecified arm, initial encounter for closed fracture	May occasionally be treated operatively if other clinical factors warrant fixation.
`S42.219A`	Fracture of shaft of humerus, unspecified, initial encounter for closed fracture	General code for humeral shaft fractures when further specificity is not documented.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`24505`	Open treatment of humeral shaft fracture; with external fixation or with open reduction and internal fixation, minimal internal fixation	May be used for alternative or adjunct fixation techniques for humeral shaft fractures when less invasive internal fixation is selected.
`24520`	Open treatment of proximal humeral (surgical neck) fracture, includes internal fixation, when performed	Used when fracture extends proximally into the surgical neck and fixation of that segment is required in the same episode of care.
`20690`	Application of external fixation system	May be performed prior to definitive internal fixation in damage-control situations or as part of staged care.
`76000`	Fluoroscopic guidance; first image	Intraoperative fluoroscopy is typically used to confirm reduction and hardware placement during open fixation.
`73560`	Radiologic exam, humerus; complete, minimum two views	Preoperative or postoperative radiographs of the humerus to document fracture and fixation outcomes.