Summary & Overview
CPT 24802: Elbow Arthrodesis with Autologous Bone Graft
CPT code 24802 represents surgical elbow immobilization with fixation devices combined with autologous bone grafting to induce bony fusion. This code captures a specialized orthopedic procedure typically used for severe joint instability, post-traumatic arthritis, infection sequelae, or failed prior reconstructions where permanent immobilization and bone healing are required. Nationally, the code is relevant for surgical orthopedic practice patterns, payer coverage determinations, and facility resource planning given the operative complexity and potential inpatient needs.
Key payers reviewed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how these payers commonly classify and reimburse complex elbow fusion procedures, and highlights considerations for prior authorization, surgical setting, and post-operative care coverage.
Readers will learn the clinical context and typical care pathway for procedures billed under CPT code 24802, expected sites of service, and the types of benchmarks and policy issues that affect reimbursement and utilization. The report summarizes common payment modifiers and administrative elements when available, and provides a concise reference for clinicians, billing staff, and policy analysts navigating coverage and coding for elbow arthrodesis with autologous bone grafting.
Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific rate tables.
Billing Code Overview
CPT code 24802 describes surgical immobilization of the elbow joint using fixation devices combined with autologous bone grafting to induce bone formation within the joint. The procedure involves creating a stable construct across the elbow to promote fusion and structural stability by harvesting a graft from another site in the patient’s body.
Service type: Surgical — orthopedic/trauma procedure focusing on elbow arthrodesis with bone grafting
Typical site of service: Hospital operating room or ambulatory surgical center, with perioperative care and possible inpatient recovery depending on patient condition and surgeon judgment.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45–70-year-old adult presenting with post-traumatic or degenerative elbow pain, instability, or ankylosis where prior conservative and reconstructive attempts have failed. The patient commonly has a history of complex intra-articular fracture, chronic osteoarthritis, severe joint instability after ligamentous injury, or infection nonunion that necessitates surgical arthrodesis of the elbow. Preoperative workflow includes history and physical, imaging (radiographs, CT as needed), medical optimization, informed consent discussing elbow fusion versus arthroplasty, and planning for autogenous bone graft harvest (commonly from the iliac crest). The procedure is performed in an operating room under general or regional anesthesia. The surgeon exposes the elbow joint, prepares joint surfaces, places fixation devices (plates, screws, intramedullary devices, or external fixator), and places autologous bone graft to induce arthrodesis. Postoperative workflow includes immobilization in a splint or cast, pain control, wound checks, radiographic confirmation of position, and staged physical therapy focusing on shoulder and hand function while the elbow fuses. Typical sites of service are the hospital operating room or an ambulatory surgery center. The service type is major orthopedic surgical procedure with grafting and fixation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or technical difficulty substantially exceeds typical for . |