CPT 24800: Elbow Arthrodesis with Local Bone Graft
CPT code 24800 represents surgical arthrodesis of the elbow with internal fixation and local bone grafting to induce bone formation and permanently immobilize the joint. The code captures a specialized orthopedic procedure used when joint stabilization and fusion are clinically indicated, often for severe post-traumatic degeneration, instability, or refractory pain. Nationally, this procedure is significant because it involves operative resources, implantable fixation devices, and grafting techniques that affect episode-of-care costs and surgical quality measures.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service, typical sites of care, common modifiers used in billing for procedural nuances, and how this code interacts with surgical service lines. The publication also summarizes typical payer considerations and coding context relevant to reimbursement workflows.
This summary prepares clinicians, billing professionals, and policy analysts to understand the clinical scope of CPT code 24800, the administrative context for billing, and where to look for benchmarks and policy updates. Data not available in the input will be identified in specific sections.
Sign up for cpt 24800 policy alerts
Get alerted when payer policies referencing 24800 are released or updated.
Billing Code Overview
CPT code 24800 describes a surgical procedure to immobilize the elbow joint using fixation devices and to promote bone formation in the joint area through a graft harvested from tissue near the elbow. This procedure is an elbow joint surgical arthrodesis with local bone grafting.
-
Service type: Surgical joint immobilization with internal fixation and local bone grafting
-
Typical site of service: Operating room or ambulatory surgical center, inpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a middle-aged adult who presents with chronic elbow pain, instability, or post-traumatic arthrosis after failed conservative care and/or prior fracture fixation. The patient often has persistent pain, limited range of motion, and radiographic evidence of joint degeneration, nonunion, or symptomatic osteoarthritis of the elbow. Preoperative workup includes history and physical exam, elbow radiographs and often CT scan to assess joint surfaces and bone stock, and preoperative anesthesia evaluation.
Surgical workflow: The patient is taken to the operating room under general or regional anesthesia. The surgeon exposes the elbow joint, harvests an autograft from a local donor site near the elbow (such as olecranon or proximal ulna), prepares the joint surfaces, and places fixation devices (plates, screws, or external fixation) to create surgical immobilization and promote arthrodesis or fusion. Bone graft material is placed to induce osseous bridging. Postoperative care includes immobilization in a splint or cast, pain control, physical therapy as indicated, and serial radiographs to confirm fusion.
Common clinical indications include painful elbow arthrosis refractory to nonoperative care, segmental bone loss with instability, or chronically symptomatic nonunion where joint-sparing reconstruction is not feasible.
Typical site of service: hospital operating room or ambulatory surgery center. Typical patient location for recovery: post-anesthesia care unit, with early outpatient follow-up for wound checks and imaging.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | (Placeholder / not a standard CMS modifier) | Not a CMS standard modifier; follow payer guidance if used. |
11 | (Principal physician of record) | Use when applicable per payer to indicate primary surgeon when required by the plan. |
22 | Increased procedural services | Use when work is substantially greater than typical for the procedure. |
23 | Unusual anesthesia | Use when procedure is performed under general anesthesia because local/regional is normally used and anesthesia was medically necessary. |
26 | Professional component | Use when billing only the professional component of a service that has a technical component (rare for surgical CPTs). |
50 | Bilateral procedure | Use if the same procedure is performed on both elbows during the same operative session. |
51 | Multiple procedures | Use when this code is billed with other distinct procedures in the same operative episode. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the procedure. |
76 | Repeat procedure by same physician | Use when an identical procedure is repeated by the same surgeon during the postoperative period (not in provided raw list; omitted from table). |
80 | Assistant surgeon | Use when a surgical assistant (qualified) aids the primary surgeon. |
81 | Minimum assistant surgeon | Use when only minimal assistance is provided. |
82 | Assistant surgeon (unqualified resident) | Use when the assistant does not meet usual assistant qualifications and payer requires this modifier. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207L00000X | Orthopaedic Surgery | Primary specialty performing elbow fusion/arthrodesis and fixation. |
| 208800000X | General Surgery | May perform complex trauma cases involving elbow in some settings. |
| 2080S0122X | Hand Surgery (Orthopedic Subspecialty) | Elbow and upper-extremity fellowship-trained surgeons who perform complex elbow reconstructions. |
| 2084P0800X | Physical Medicine & Rehabilitation | Involved in pre- and postoperative rehabilitation planning. |
| 363L00000X | Anesthesiology | Provides general or regional anesthesia for the procedure. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M19.011 | Primary osteoarthritis, right elbow | Advanced osteoarthritis causing pain and loss of function that may warrant elbow fusion. |
M19.012 | Primary osteoarthritis, left elbow | Same as above for the left side; indicates side-specific pathology. |
M84.40XA | Pathologic fracture of unspecified elbow, initial encounter | Pathologic or nonhealing fractures with joint destruction may require arthrodesis. |
M84.14 | Nonunion of fracture of the humerus | Chronic nonunion involving the distal humerus/elbow can necessitate surgical immobilization with grafting. |
M20.21 | Post-traumatic arthropathy of elbow | Post-traumatic degenerative change leading to pain and instability treated with fusion. |
M25.51 | Pain in right elbow | Symptom code commonly associated with underlying conditions leading to fusion. |
M25.52 | Pain in left elbow | Symptom code for left-sided elbow pain associated with degenerative or post-traumatic conditions. |
T84.8XXA | Other complications of internal orthopedic prosthetic devices, implants and grafts, initial encounter | Indicates complications from prior hardware that may lead to revision and arthrodesis. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
24800 | Arthrodesis, elbow; includes internal fixation, with autograft | Primary procedure: surgical immobilization of the elbow joint with fixation and local grafting to induce fusion. |
20680 | Removal of implant; deep (e.g., plates, screws) | Often performed preoperatively or concurrently if prior hardware is present and impedes fusion. |
20938 | Autograft, any donor area; includes obtaining graft (includes trunk, fibula, iliac crest — code for local grafting varies) | Used when additional autograft is harvested from a donor site; documents graft harvest when not bundled. |
29807 | Arthroscopy, elbow, surgical; synovectomy, debridement, or limited procedures | May be performed prior to or in staged fashion for joint assessment or debridement before open arthrodesis. |
20670 | Bone graft, any donor area; packing of a bone cavity (includes obtaining graft) | Adjunct when bone grafting materials are placed to promote fusion; documents graft placement activities. |
99024 | Postoperative follow-up visit, global period (hospital or ASC) | Represents routine postoperative care visits in the global surgical period following fusion; used by some payers for billing context. |