Closed treatment of a humeral shaft fracture using manual manipulation, with or without the addition of skeletal traction.

Verified May 8, 2026 · 5 sources ↓

Medicare: $582.18
Work RVU: 5.26
Global, days: 90
Region: Elbow

Drawn from CMSNIHCgsmedicareFindacode

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Mechanism of injury and clinical presentation documented in the encounter note
Pre- and post-manipulation imaging confirming fracture location along the humeral shaft and alignment achieved
Explicit notation that manipulation was performed — 'closed reduction' or 'manual reduction' by name; notes that only say 'treated' are audit targets
Laterality documented in both the operative/procedure note and the ICD-10 diagnosis code selection
If skeletal traction applied, document traction type, pin site, and weight used
Global period plan documented: cast or splint applied, follow-up schedule, and return precautions

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 24505 describes closed (non-operative) treatment of a fracture along the shaft of the humerus that requires hands-on manipulation to achieve acceptable alignment, with or without skeletal traction applied to maintain reduction. No incision is made. The distinction from 24500 is the manipulation: if the fracture is treated without any manipulation, bill 24500 instead. Skeletal traction, when used, is included and not separately billable.

The code carries a 90-day global period. All routine follow-up — casting checks, repeat X-rays to confirm alignment, splint or cast adjustments — is bundled through day 90. If a new, unrelated problem is evaluated during the global window, append modifier 24 to the E/M. If the fracture displaces and requires a subsequent manipulative reduction during the global, that's a staged or related service — use modifier 58 if planned, 78 if the patient unexpectedly returns to the facility setting.

Humeral shaft fractures most often map to ICD-10 codes in the S42.3x range (closed fracture of shaft of humerus). Confirm laterality on both the diagnosis and the claim — LT or RT is required. Bilateral humeral shaft fractures treated simultaneously require modifier 50 and supporting documentation that both sides were independently manipulated.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (5.26) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (17.43) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	5.26
Practice expense RVU	10.98
Malpractice RVU	1.19
Total RVU	17.43
Medicare national rate	$582.18
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$582.18
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 24505 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing laterality modifier (LT or RT) causing claim to reject or pend for additional information
Billing a separate E/M on the same day without modifier 25, or during the global period without modifier 24
ICD-10 code points to humeral neck or proximal humerus instead of humeral shaft, mismatching the CPT descriptor
Unbundling skeletal traction as a separate billable service when it is included in 24505
Billing 24505 when no manipulation was performed — that work maps to 24500

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What separates 24505 from 24500?

Manipulation. If you reduced the fracture by hand (or with traction), bill 24505. If the fracture was acceptably aligned without any manipulation, bill 24500. The operative note must state manipulation was performed — don't let it be implied.

02Is skeletal traction separately billable when used with 24505?

No. Skeletal traction is explicitly included in 24505's descriptor ('with or without skeletal traction'). Billing a traction code separately will be bundled and denied under NCCI edits.

03How do you handle a fracture that re-displaces during the 90-day global and needs repeat manipulation?

If the repeat manipulation was anticipated as part of staged care, use modifier 58. If the patient unexpectedly returned to a facility setting for an unplanned related procedure, use modifier 78. Document clinical justification either way.

04Can 24505 be billed with an E/M on the same day?

Yes, but only with modifier 25 appended to the E/M. The E/M must be significant and separately identifiable from the fracture management decision itself. A brief pre-procedure assessment alone won't support a separate E/M.

05What ICD-10 codes support 24505?

Fractures of the humeral shaft map to the S42.3x category in ICD-10-CM. Select the code that reflects laterality, displacement status, and encounter type (initial, subsequent, sequela). A proximal or distal humerus code will mismatch the CPT descriptor and trigger denial.

06Is modifier 50 appropriate if both humeral shafts are fractured and manipulated in the same session?

Yes. Bill 24505 once with modifier 50 and document independent manipulation of each side. Medicare typically reimburses bilateral procedures at 150% of the single-procedure allowable. Verify bilateral policy with the specific payer — some require two line items with LT and RT instead of a single line with 50.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures the fracture location (humeral shaft, not neck or proximal humerus), manipulation technique, traction details if used, pre- and post-reduction alignment assessment, and laterality — all from dictation. That prevents the two most common denials: ICD-10 site mismatch and missing laterality, both of which trigger automatic claim holds.

See how Mira captures CPT 24505 documentation