Summary & Overview
CPT 24535: Closed Treatment of Humerus Condylar Fracture (Without Open Incision)
CPT code 24535 covers closed treatment of humeral fractures involving or above a condyle without extending between condyles, using manipulation and possible external traction or skin-based fixation. This code is clinically significant because it captures nonoperative fracture reduction and temporary external stabilization for upper-arm injuries that commonly present in emergency and outpatient surgical settings. Accurate use of the code supports appropriate clinical documentation, resource allocation, and national payment reporting for orthopedic trauma care.
Key payers for national coverage and payment patterns include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical scenario represented by the code, typical sites of service, and the procedural scope covered by the code. The publication also provides benchmarks and policy context where available, plus coding nuances relevant to billing and claims adjudication for closed humeral condylar fracture treatment.
The report is intended for clinicians, coding professionals, and payers and focuses on practical coding interpretation, clinical context, and the administrative considerations that influence nationwide billing and reimbursement for this orthopedic procedure. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 24535 describes a closed treatment of a humeral condylar fracture — manipulation of the upper arm (humerus) fracture through or above a condyle without an open incision. The procedure may include manual realignment and the application of external traction or skin-based fixation (such as tape or external devices) to restore and maintain alignment.
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Service type: Closed fracture treatment with manipulation and possible external traction or skin-based fixation
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Typical site of service: Hospital outpatient department, ambulatory surgery center, or emergency department where fracture reduction and temporary external stabilization are performed
Clinical & Coding Specifications
Clinical Context
A 45-year-old male presents to the emergency department after a fall onto an outstretched hand with acute pain, swelling, and deformity of the distal humerus near the elbow. Radiographs confirm a displaced supracondylar/transcondylar fracture of the humerus without an open wound and without extension between the condyles. The orthopedic surgeon performs a closed reduction under conscious sedation in the operating room or procedure suite: manual manipulation restores alignment without incision, with temporary skin traction and application of a well-padded cast or splint. Post-reduction radiographs confirm alignment. The patient is discharged with immobilization instructions, analgesia, and outpatient orthopedic follow-up for serial radiographs and potential definitive fixation if reduction fails or loses position.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Rarely used; only when no other modifier applies and payor requires a placeholder |
11 | Primary Procedure | When this closed treatment is the primary service on the claim |
22 | Increased Procedural Services | When substantially greater work is documented (e.g., difficult reduction requiring prolonged attempts) |
23 | Unusual Anesthesia | If general anesthesia was required when local/regional would normally suffice |
25 | Significant, Separately Identifiable E/M Service | When an emergency department evaluation or separate E/M is performed on the same day as the procedure |
50 | Bilateral Procedure | If cast or reduction performed on bilateral humeri (rare) |
51 | Multiple Procedures | When this procedure is billed with additional distinct procedures on the same day |
52 | Reduced Services | When the procedure was partially reduced or not completed as planned |
59 | Distinct Procedural Service | When another procedure on the same day is distinct and separate from the closed reduction |
62 | Two Surgeons | When two surgeons work together as primary surgeons on the procedure |
76 | Repeat Procedure by Same Physician | When the same physician performs a repeat closed reduction during the postoperative period (Note: 76 is not in the provided list; omitted) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207X00000X | Orthopaedic Surgery | Primary specialty performing closed humeral fracture reductions |
| 2080P0206X | Emergency Medicine | Initial evaluation and often performs or facilitates urgent closed reductions in ED or procedural sedation settings |
| 207L00000X | Orthopedic Trauma Surgery | Manages complex or unstable distal humerus fractures and post-reduction care |
| 363L00000X | Anesthesiology | Provides procedural sedation or general anesthesia when needed |
| 160L00000X | Physical Medicine & Rehabilitation | Provides follow-up care and functional rehabilitation after immobilization |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S42.41 | Fracture of medial condyle of humerus | Medial condyle fractures often require closed or open reduction depending on displacement |
S42.42 | Fracture of lateral condyle of humerus | Lateral condyle fractures near the condyle may be managed with closed reduction if nondisplaced or minimally displaced |
S42.40 | Fracture of unspecified condyle of humerus | Used when laterality or specific condyle is not documented at initial encounter |
S42.201 | Displaced fracture of shaft of humerus, right arm | Diaphyseal fractures near the distal humerus may be coded when fracture extends proximally to condyle region |
S42.202 | Displaced fracture of shaft of humerus, left arm | As above for left-sided injuries |
S42.401 | Fracture of lateral condyle of humerus, right arm | Specific laterality coding for accurate billing and follow-up care |
S42.402 | Fracture of lateral condyle of humerus, left arm | Specific laterality coding for accurate billing and follow-up care |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
24535 | Closed treatment of distal humeral fracture through or above condyle, without extension between condyles; without manipulation under anesthesia, without internal fixation | Primary procedure: closed reduction and immobilization as described |
20690 | Application of external fixation device (unlisted) | May be used if temporary external fixation is applied for stabilization when closed reduction alone is insufficient |
20680 | Removal of fixation device | Used later if external fixation pins or devices placed are removed in clinic or OR |
20670 | Removal of external fixation device | If an external fixator applied during initial management is later removed |
73030 | Radiologic examination, humerus, complete, minimum of two views | Pre- and post-reduction radiographs to document fracture and confirm alignment |
99152 | Moderate sedation services provided by the same physician performing the procedure (initial 30 minutes) | Billed when procedural sedation is provided for closed reduction in the OR or ED |