Closed treatment of a supracondylar or transcondylar humeral fracture, with or without intercondylar extension, performed without manipulation.

Verified May 8, 2026 · 6 sources ↓

Medicare: $434.21
Work RVU: 3.6
Global, days: 90
Region: Elbow

Drawn from CMSAAOSPayerprice

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Fracture characterization: supracondylar vs. transcondylar, displaced vs. non-displaced, and whether intercondylar extension is present
Explicit documentation that no manipulation was performed and clinical rationale (e.g., acceptable alignment on imaging)
Imaging report or direct reference to fluoroscopic or plain-film findings confirming fracture pattern and position
Type of immobilization applied (long-arm cast, sugar-tong splint, etc.) and laterality (left or right)
Neurovascular status of the affected extremity documented pre- and post-immobilization
Patient age and clinical context — pediatric vs. adult supracondylar fractures carry different management implications and audit scrutiny

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 57 Decision for surgery 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 24530 covers closed management of a supracondylar or transcondylar distal humerus fracture that does not require manipulation to achieve acceptable alignment. The fracture may have intercondylar extension. Because no reduction maneuver is performed, this code applies to stable, non-displaced, or minimally displaced fractures managed with immobilization — typically a long-arm cast or splint — and does not involve percutaneous pinning or open fixation. If manipulation is required, step up to 24535. If percutaneous skeletal fixation is added, use 24538 instead.

The 90-day global period covers the initial cast application, routine follow-up visits, imaging interpretation tied to fracture monitoring, and cast or splint changes through day 90. Any E/M service unrelated to the fracture management during that window requires modifier 24. If the decision for surgery is made the day of or day before the procedure at a separate E/M visit, append modifier 57 to that E/M code.

Site-of-service matters here: this procedure is performed in the office, emergency department, or outpatient hospital setting. The HOPD and ASC payment rates differ from the physician fee schedule — see the site-of-service comparison table on this page. Bilateral fractures are uncommon but, if treated in the same session, append modifier 50 and document both sides explicitly.

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 (3.6) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (13) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	3.6
Practice expense RVU	8.65
Malpractice RVU	0.75
Total RVU	13
Medicare national rate	$434.21
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	$434.21
HOPD (APC 5111) Hospital outpatient department	$252.01
ASC (PI A2) Ambulatory surgical center (freestanding)	$135.54

Common denial reasons

The recurring reasons claims for CPT 24530 get rejected.

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

Upcoding flag: payer downcodes to 24530 when operative note for 24535 lacks documentation of a manipulation maneuver
Global period conflict: E/M visit billed within 90-day global without modifier 24, triggering automatic bundling denial
Missing laterality: claim submitted without LT or RT modifier when payer policy requires it, resulting in rejection
Incorrect code selection: 24530 denied because imaging or notes describe a displaced fracture requiring reduction, which maps to 24535
Duplicate claim: 24530 billed same-day as casting code (29000-series) without modifier 59, triggering NCCI bundling edit

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01When does 24530 cross over to 24535 or 24538?

Use 24535 when closed reduction with manipulation is performed, with or without traction. Use 24538 when percutaneous pins or skeletal fixation are placed. Document the decision point explicitly — if you attempted manipulation and achieved reduction, 24535 applies even if the final position looks similar to a non-manipulated case.

02Can I bill a casting code on the same day as 24530?

Generally no. Initial cast or splint application is considered part of the fracture care global package for 24530. Billing a 29000-series code same-day without modifier 59 and a distinct clinical justification will trigger an NCCI bundling edit.

03What modifier applies if the same surgeon treats a new, unrelated fracture during the 90-day global period?

Use modifier 79 (unrelated procedure by the same physician during the postoperative period). Modifier 78 is for unplanned returns for a procedure related to the original surgery — do not invert these two.

04Is modifier 57 ever needed with 24530?

Yes, if you bill a separate E/M visit on the day of or day before the procedure and that visit is where the decision for surgery was made. Append modifier 57 to the E/M code — not to 24530 itself. Because 24530 carries a 90-day global, modifier 57 is the correct tool for that pre-op visit.

05Does 24530 require a specific place of service to be paid correctly?

CMS pays different facility rates depending on whether the service is rendered in a non-facility (office) vs. facility (HOPD, ASC, ER) setting. The physician component is the same, but the facility payment varies. If you perform this in the ED and bill as non-facility, expect a claim adjustment. Match your place-of-service code to where the procedure actually occurred.

06How do I handle bilateral supracondylar fractures treated in the same session?

Append modifier 50 to 24530 and document both sides in the encounter note. Some payers require separate line items with LT and RT instead of a single line with modifier 50 — verify your payer's preference before submitting.

Sources & references

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

Mira Scribe

Mira's AI scribe captures fracture type (supracondylar vs. transcondylar), displacement status, presence or absence of intercondylar extension, whether manipulation was attempted or withheld and the clinical rationale, immobilization type and laterality, and neurovascular exam findings. This prevents the most common audit flag on 24530 — operative or encounter notes that describe fracture characteristics consistent with 24535 while the claim is submitted under 24530, or vice versa.

See how Mira captures CPT 24530 documentation