Summary & Overview
CPT 24666: Radial Head/Neck Prosthetic Replacement
CPT code 24666 denotes open surgical excision of the radial head or neck with implantation of a prosthesis to treat fractures of the proximal radius. This procedure addresses complex or displaced radial head/neck fractures that require removal of damaged bone and prosthetic replacement, often with internal fixation to restore joint stability and forearm function. Nationally, 24666 is relevant for orthopedic trauma care pathways and surgical quality measurement, given its role in elbow fracture management and postoperative rehabilitation planning.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing overview of the procedure, context on typical sites of service (hospital OR and ambulatory surgical centers), and summaries of common billing considerations tied to this code. The publication offers benchmarks and policy context where available, highlights clinical implications for care coordination and rehabilitation, and outlines areas where payers commonly focus utilization review and medical necessity criteria.
This material is intended for billing professionals, orthopedic surgeons, and health policy analysts seeking a concise, nationally focused reference on coding and administrative considerations for prosthetic replacement of the radial head/neck using CPT code 24666. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 24666 describes a surgical procedure to treat a fracture at the head or neck of the radius through an incision at the elbow. The provider excises a portion of bone at the proximal radius and replaces it with a prosthesis; fixation with screws or wires may be applied to stabilize the fracture.
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Service type: Surgical open repair with prosthetic replacement of the radial head/neck
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 68-year-old right-hand-dominant male presents after a fall onto an outstretched hand with acute pain, swelling, and limited forearm rotation at the lateral elbow. Radiographs and CT confirm a comminuted fracture of the radial head with loss of articular surface and instability of the radiocapitellar joint. Nonoperative management is not appropriate due to displacement and mechanical block. The orthopedic surgeon schedules an open radial head excision and prosthetic replacement through a lateral elbow exposure under general anesthesia. Intraoperatively the surgeon resects the damaged radial head, prepares the neck, sizes and implants a metallic radial head prosthesis, and secures it for stability. Perioperative workflow includes preoperative consent, anesthesia evaluation, sterile prep and draping in the operating room, device implantation, intraoperative fluoroscopy to confirm alignment, postoperative recovery with neurovascular checks, and discharge planning with early range-of-motion instructions and outpatient follow-up for physical therapy and radiographic surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician's professional interpretation component (rare for surgery; more relevant for associated imaging when billed separately). |
50 |