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CPT 24516: Humeral Shaft Internal Fixation with Intramedullary Rod
CPT code 24516 represents surgical internal fixation of a humeral shaft fracture, commonly performed with an intramedullary rod and optional cerclage or locking screws. This code matters nationally because humeral shaft fractures are a frequent orthopedic injury requiring operative management to restore limb function and reduce long-term disability. Accurate coding for this procedure affects hospital and surgeon billing, resource allocation, and quality measurement for orthopedic trauma care.
Key payers discussed 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 which payers commonly reimburse for operative fracture care. The publication also summarizes benchmarks and policy-relevant considerations such as reimbursement patterns, prior authorization trends, and documentation elements that influence claims adjudication. Clinical readers will gain clarity on the procedure's intent and typical setting, while billing and policy audiences will find guidance on where to look for reimbursement policies and common coverage considerations nationally.
Data not available in the input is explicitly noted where payer-specific rates, related codes, ICD-10 pairings, and associated taxonomies are absent.
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Billing Code Overview
CPT code 24516 describes surgical treatment of a humeral shaft fracture using internal fixation implants such as an intramedullary rod, with optional use of cerclage and/or locking screws. This procedure is an operative fracture treatment of the humeral diaphysis and involves stabilization of the humeral shaft to restore alignment and enable healing.
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Service type: Surgical open or closed internal fixation of the humeral shaft
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Typical site of service: Hospital operating room or ambulatory surgical center
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