Summary & Overview
CPT 24575: Open Repair of Epicondylar Humerus Fracture
CPT code 24575 denotes an open surgical repair of an epicondylar fracture of the humerus—a procedure to expose, reduce and stabilize a fracture of the bony prominences near the elbow, often using internal fixation. This code is used nationally to capture operative management of these fractures and informs payment and clinical reporting for orthopedic trauma care. Key payers in national coverage analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare.
Readers will find a concise overview of the clinical context for CPT code 24575, the typical sites of service (hospital operating room or ambulatory surgical center), and the service type (open surgical fracture repair). The publication summarizes how the code is applied in clinical documentation and billing, common modifiers associated with surgical services, and what to look for in claims line items. It also outlines typical benchmarking topics — utilization rates, site-of-service patterns, and payer coverage themes — and highlights policy and coding considerations that affect national claims processing and reporting. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 24575 describes an open treatment of an epicondylar fracture of the humerus, an operative procedure to repair a fracture of the small bony prominence on either side of the elbow above the condyle. The provider makes an incision at the affected site, directly visualizes the fracture, and performs reduction and fixation which may include application of hardware to stabilize the bone fragments during healing.
Service type: Open surgical fracture repair (orthopedic procedure)
Typical site of service: Hospital operating room or ambulatory surgical center (inpatient or outpatient surgical settings)
Clinical & Coding Specifications
Clinical Context
A 32-year-old right-hand-dominant construction worker presents after a fall onto an outstretched hand with acute lateral elbow pain, swelling, and inability to actively extend the forearm. Radiographs and CT demonstrate a displaced lateral epicondyle fracture of the distal humerus with articular extension and instability. The orthopedic surgeon schedules an open reduction and internal fixation to restore alignment and elbow stability.
Preoperative workflow includes history and physical, informed consent, preoperative imaging review (X-ray and CT as needed), anesthesia evaluation (general or regional block), and perioperative antibiotics. In the operating room, a lateral skin incision is made over the epicondyle, fracture fragments are reduced, and fixation (screws and/or a small plate) is applied. Intraoperative fluoroscopy confirms reduction. Postoperative care includes immobilization in a posterior splint, pain control, wound care instructions, and an early supervised rehabilitation plan with progressive range-of-motion exercises when stable. Follow-up visits assess wound healing and radiographic union with removal of hardware if indicated for symptomatic prominence.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the procedure is performed on the left epicondyle |