Open surgical repair of a supracondylar or transcondylar distal humerus fracture, with internal fixation when used, where the fracture does not extend into the intercondylar region.

Verified May 8, 2026 · 6 sources ↓

Medicare: $860.41
Total RVUs: 25.76
Global, days: 90
Region: Elbow

Drawn from CMSFindacodeAAPCFastrvuNIH

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Confirm fracture pattern is supracondylar or transcondylar with no intercondylar extension — imaging and operative note must both support this
Specify fixation method used (K-wires, lateral-entry pins, medial-lateral crossed pins, plate and screws) and implant details
Document surgical approach by name (anterolateral, posterior triceps-splitting, triceps-reflecting, etc.) — 'standard approach' flags audits
Record neurovascular status pre- and post-op, including anterior interosseous nerve and radial pulse documentation
Include fluoroscopic confirmation of reduction and fixation adequacy in the operative note
Document indication for open rather than closed or percutaneous treatment (failed closed reduction, vascular injury, open fracture, etc.)

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 51 Multiple procedures 58 Staged or related 59 Distinct service 62 Co-surgeons 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 24545 covers open treatment of a supracondylar or transcondylar humeral fracture — the distal humerus above the elbow joint — without intercondylar extension. Internal fixation (e.g., crossed K-wires, lateral-entry pins, or plate-and-screw constructs) is included in the code when performed; it does not need to be billed separately. The critical distinction from 24546 is the absence of intercondylar extension: if the fracture splits between the condyles, you're in 24546 territory.

This code carries a 90-day global period. All routine post-op visits, wound checks, and hardware monitoring through day 90 are bundled. Modifier 78 covers an unplanned return to the OR for a related complication (e.g., hardware failure, wound dehiscence) during the global. Modifier 79 applies if the same surgeon performs an unrelated procedure in that window. Use modifier 24 on any E/M billed for an unrelated problem during the 90-day period.

Assistant surgeon participation is recognized for this code. Bill modifier 80 for an MD assistant, or AS for a PA, NP, or CNS assisting at surgery. Co-surgeon arrangement (modifier 62) is available when two surgeons of different skills each perform a distinct part of the procedure and document accordingly.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	12.82
Practice expense RVU	10.27
Malpractice RVU	2.67
Total RVU	25.76
Medicare national rate	$860.41
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	$860.41
HOPD (APC 5115) Hospital outpatient department	$13,116.76
ASC (PI J8) Ambulatory surgical center (freestanding)	$9,131.77

Common denial reasons

The recurring reasons claims for CPT 24545 get rejected.

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

Fracture coded as 24545 but imaging or op note describes intercondylar extension — should be 24546
Internal fixation billed separately as an additional code when it is already included in 24545
Assistant surgeon claim denied because payer-specific policy doesn't allow modifier 80 without prior authorization for this code
E/M billed during the 90-day global without modifier 24, triggering a bundling denial
ICD-10 diagnosis code does not match the fracture site or laterality specified in the operative report

Frequently asked questions

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

01What separates 24545 from 24546?

The intercondylar extension. If the fracture column splits between the two condyles, bill 24546. If the fracture is purely supracondylar or transcondylar with no intra-articular condylar split, bill 24545. Imaging and the operative note must both support whichever you select.

02Is internal fixation billed separately when performed with 24545?

No. Internal fixation is included in 24545 regardless of whether K-wires, pins, or a plate construct is used. Billing a separate hardware code alongside 24545 will be denied as unbundling.

03Can I bill an E/M during the 90-day global if the patient presents with an unrelated problem?

Yes, but you must append modifier 24 to the E/M code and document clearly that the visit addressed a problem unrelated to the fracture repair. Without modifier 24, the claim bundles into the global and is denied.

04When does modifier 22 apply to 24545?

When the procedure required substantially more work than typical — for example, a severely comminuted fracture requiring extended operative time, significant neurovascular repair, or conversion from a planned percutaneous approach. Attach a cover letter with operative time, complexity narrative, and a copy of the op note. Payers vary on how they review modifier 22, but documentation must be specific.

05How do I bill if the patient returns to the OR for a related complication, such as hardware failure, within the 90-day global?

Use modifier 78 on the return procedure code. Modifier 78 signals an unplanned return to the OR for a related procedure during the postoperative period. Do not use modifier 79, which is for unrelated procedures.

06Is this procedure performed bilaterally?

Bilateral supracondylar fractures are rare but can occur in high-energy trauma. If both elbows are treated at the same operative session, append modifier 50 and verify payer policy — some payers require LT and RT on separate line items instead.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures the fracture pattern (supracondylar vs. transcondylar, presence or absence of intercondylar extension), fixation construct, surgical approach by name, and pre/post-op neurovascular exam from dictation. That prevents the most common 24545-vs-24546 upcoding flag and closes the documentation gap auditors target when the op note omits approach or implant specifics.

See how Mira captures CPT 24545 documentation