Summary & Overview

CPT 24935: Upper Limb Lengthening with Bone Graft

CPT code 24935 represents surgical limb-lengthening of an amputated upper extremity using a bone graft, typically harvested from the patient. Nationally, this is an important reconstructive procedure for restoring limb length and improving prosthetic fit and function after traumatic or surgical amputation. The code captures a specialized orthopedic service that can have significant implications for surgical resource use, rehabilitation planning, and post-operative care coordination.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, typical settings of care, and the kinds of benchmarks and policy topics commonly associated with complex reconstructive surgery claims. The publication outlines expected service lines and sites of service, discusses common modifiers used in practice (listed separately), and highlights areas where coding clarity and documentation affect coverage and payment workflows.

This summary provides a concise reference for payers, billing professionals, and clinical teams seeking to understand the role of CPT code 24935 in surgical and post-operative care pathways, and what operational and policy considerations typically accompany billing for specialized limb reconstruction.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 24935upper extremity surgerybone graftinglimb lengtheningorthopedic reconstructionsurgical billingambulatory surgery centerhospital operating room

Billing Code Overview

CPT code 24935 describes a surgical procedure that increases the length of an amputated upper limb using a bone graft, typically harvested from the patient's own body. This procedure is an orthopedic reconstructive surgery aimed at restoring limb length and improving function after amputation.

Service type: Surgical bone grafting for limb-lengthening in an upper extremity amputation
Typical site of service: Hospital operating room or ambulatory surgery center where orthopedic reconstructive procedures are performed

Clinical & Coding Specifications

Clinical Context

A 34-year-old male with a traumatic transradial amputation of the dominant left forearm after a high-energy crush injury presents for reconstructive lengthening to optimize prosthetic fitting and restore forearm length. The patient completed initial wound healing and stump maturation, and imaging documents adequate bone stock for autogenous corticocancellous grafting. Preoperative workflow includes history and physical, vascular assessment, templating radiographs, informed consent discussing risks of nonunion and infection, and coordination with the prosthetics team. In the operating room under general anesthesia, the orthopedic or plastic surgeon exposes the amputated radius and ulna stumps, prepares recipient sites, harvests an autograft (commonly from the ipsilateral or contralateral iliac crest), shapes and implants the graft to increase limb length, secures fixation with plates, screws or intramedullary devices, confirms alignment radiographically, and closes. Postoperative care includes pain control, infection prophylaxis, immobilization or controlled mobilization, serial radiographs to monitor graft incorporation, physical and prosthetic rehabilitation, and follow-up visits for suture removal and functional assessment.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the work, time, and intensity substantially exceed the usual for the procedure (document specific reasons).

Taxonomy Code	Specialty	Notes
207L00000X	Orthopaedic Surgery	Orthopedic surgeons commonly perform long bone grafting and stump reconstruction.
208W00000X	Plastic Surgery	Plastic surgeons perform limb reconstruction and soft-tissue management with bone grafting.
2080P0222X	Hand Surgery	Hand and microsurgeons manage distal upper limb amputations and reconstructive lengthening.
207X00000X	General Surgery	General surgeons may be involved in complex trauma centers for multidisciplinary care.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`20937`	Structural allograft for spine, long bone, or other sites; includes obtaining and shaping the graft	Alternative graft source when autograft is not used; may be billed when structural allograft is implanted to increase limb length.
`20936`	Autograft, allograft for spine, long bone, or other sites, structural; includes harvesting when applicable	Used when autogenous structural grafts are harvested and implanted; documents graft placement in long-bone reconstruction.
`20680`	Removal of implant; deep (requires anesthesia)	May be performed later if fixation hardware used for the bone graft needs removal.
`20690`	Insertion of needle or catheter into bone (bone marrow aspiration for graft)	May be used if bone marrow aspirate is obtained intraoperatively to augment graft biologics.
`11010`	Debridement of open wound, bone; limited	May be performed prior to grafting if residual infection or nonviable bone requires debridement.
`29880`	Arthroscopy, elbow, surgical (if arthroscopic assistance used)	Rarely used adjunctively if joint work or arthroscopic evaluation is required during reconstruction.

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