Summary & Overview

CPT 24546: Open Repair of Humerus Fracture Through or Above Condyle

CPT code 24546 represents an open surgical procedure to treat fractures of the humerus through or above a condyle that extend between the two condyles, typically performed as open reduction with possible internal fixation. This operative code is clinically important because humeral condylar fractures can require timely surgical stabilization to restore joint alignment, preserve elbow function, and reduce the risk of long-term disability. Nationally, surgical management of these injuries impacts hospital surgical volumes, orthopedic specialty utilization, and payer expenditures for trauma and elective reconstruction services.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure and an overview of expected sites of service. The publication summarizes common billing and documentation considerations, lists common modifiers associated with operative and laterality reporting, and outlines service-line implications for orthopedic surgery and hospital revenue cycle teams. The content also provides benchmark-oriented guidance on where to look for policy updates and prior authorization requirements. Data not available in the input is clearly identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 24546humerus fractureopen reduction internal fixationorthopedic surgeryelbow condylesurgical procedureoperative repairambulatory surgical centerhospital surgery

Billing Code Overview

CPT code 24546 describes an open treatment of a humeral fracture through or above a condyle extending between the two condyles. The procedure involves a surgical incision in the upper arm with direct exposure of the fracture site and may include internal fixation hardware applied to stabilize the humerus during healing.

Service type: Open surgical fracture repair (open reduction and internal fixation)

Typical site of service: Hospital operating room or ambulatory surgical center (inpatient or outpatient surgical setting depending on patient status and complexity)

Clinical & Coding Specifications

Clinical Context

A 42-year-old right-hand-dominant male presents after a fall from a ladder with severe left distal humerus pain, swelling, and limited elbow motion. Imaging demonstrates a displaced supracondylar/transcondylar humeral fracture extending between the medial and lateral condyles with articular involvement. The orthopaedic surgeon schedules an open reduction and internal fixation under general anesthesia. In the operating room, the provider makes a lateral arm incision, achieves anatomic reduction of the articular surface, and applies plates and screws to stabilize the fracture. Postoperative workflow includes documentation of surgical approach, implants used, estimated blood loss, operative time, intraoperative neurovascular status, and placement of a dressing and immobilizer. Immediate postoperative orders address pain control, neurovascular checks, and instructions for activity and follow-up imaging and clinic visit for suture removal and rehabilitation planning.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When only the physician component of a service is billed separate from technical/ facility services.
`50`	Bilateral procedure	When both humeri are repaired during the same operative session.
`51`	Multiple procedures	When additional unrelated surgical procedures are performed at the same session.
`52`	Reduced services	When the procedure is partially reduced or not completed as described.
`53`	Discontinued procedure	When the procedure is terminated due to extenuating circumstances or patient condition.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct portions of the operation.
`66`	Surgical team	When a surgical team approach is used for complex reconstruction requiring multiple surgeons.
`78`	Return to operating room for related procedure during global period	When a complication requires a related, return-to-OR procedure within the global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	For an unrelated surgery performed during the global period.
`58`	Staged or related procedure or service by same physician during the postoperative period	When this operation is planned or staged as part of a treatment plan.
`22`	Increased procedural services	When the work required is substantially greater than normally required.
`24`	Unrelated evaluation and management service during postoperative period	When an E/M visit unrelated to the surgery occurs during the global period.
`59`	Distinct procedural service	When a separate, distinct procedure is performed at a different anatomic site or at a separate session.

Taxonomy Code	Specialty	Notes
`207L00000X`	Orthopaedic Surgery	Primary specialty performing open humeral fracture fixation.
`207LP2900X`	Hand Surgery	Involvement when fracture includes distal articular surface affecting elbow/hand function.
`208800000X`	General Surgery	Occasionally involved in trauma centers for initial trauma management and coordination.
`207R00000X`	Sports Medicine	Orthopaedic subspecialists focusing on complex elbow injuries and reconstruction.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S42.41`	Fracture of lower end of humerus, unspecified	Captures distal humeral fractures that commonly require open reduction and internal fixation.
`S42.42`	Fracture of lateral condyle of humerus	Lateral condyle fractures of the distal humerus that may need ORIF.
`S42.43`	Fracture of medial condyle of humerus	Medial condyle involvement requiring surgical stabilization.
`S42.44`	Fracture of supracondylar humerus	Supracondylar fractures extending toward condyles commonly treated with ORIF in adults.
`S42.46`	Fracture of transcondylar humerus	Fractures extending between condyles; directly describes the anatomic injury for `24546`.
`S42.40`	Fracture of lower end of humerus, unspecified part	General code when part not further specified but clinically relevant to operative fixation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`24546`	Open treatment of humeral supracondylar or transcondylar fracture, with internal fixation	Primary operative code describing open reduction and internal fixation of the distal humerus fracture.
`20680`	Removal of deep implant; deep (e.g., buried)	May be performed at a later date if hardware removal is indicated after healing.
`20690`	Application of external fixation device (without minor open exposure of fracture site)	Used when an external fixator is placed as a temporizing or adjunctive measure in complex fractures.
`29848`	Arthroscopy, elbow, surgical; with lysis of adhesions, with or without manipulation	May be used postoperatively for arthroscopic management of stiffness following fixation.
`73030`	Radiologic examination; humerus, minimum two views	Preoperative and postoperative radiographs to document fracture and fixation alignment.
`99024`	Postoperative follow-up visit, global period, related to the original procedure	Used for routine postoperative visits during the global period to document healing and recovery.