Fracture care · Elbow

24579

Open surgical repair of a humeral condyle fracture, accessing the fracture site through an incision and stabilizing the bone with internal fixation hardware.

Verified May 8, 2026 · 6 sources ↓

Medicare
$780.25
Total RVUs
23.36
Global, days
90
Region
Elbow
Drawn from CMSAAPCFindacodeMdclarityPayerprice

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

  • Specify which condyle is fractured (lateral or medial) and the laterality (left or right arm)
  • Operative note must name the surgical approach — lateral, medial, or extensile — not just 'standard approach'
  • Document fracture displacement, angulation, and stability findings that justify open rather than closed or percutaneous treatment
  • Record all implants used (plates, screws, pins) including manufacturer and implant identifiers if required by facility
  • Document neurovascular status pre- and post-reduction, especially radial nerve and ulnar nerve assessment
  • Pre-operative imaging (X-ray, CT if obtained) linked to the operative diagnosis and fracture classification

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 24579 covers open treatment of a humeral condylar fracture — one of the two rounded articular projections at the distal humerus forming the elbow joint. The surgeon opens the elbow, reduces the displaced condylar fragment, and stabilizes it with plates, screws, or pins. This is distinct from percutaneous fixation (24582) and from periarticular fracture-dislocation repairs (24586–24587).

Indications include displaced or unstable condylar fractures that cannot be reduced closed, fractures with significant angulation or rotation, and those involving neurovascular compromise. The 90-day global period covers the operative day, any day-before visit, and all routine post-op care through day 90. E/M services during that window require modifier 24 (unrelated) or 25 (same-day, separate problem). Unplanned return to the OR for a related complication bills with modifier 78; an unrelated procedure in the global window uses modifier 79.

Site of service matters. HOPD and ASC payments differ significantly — see the Site of Service comparison table. Laterality modifiers LT and RT are expected on all extremity claims; missing them is a top reason for payer rejection on elbow fracture codes.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU11.15
Practice expense RVU9.91
Malpractice RVU2.3
Total RVU23.36
Medicare national rate$780.25
Global period90 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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$780.25
HOPD (APC 5115)
Hospital outpatient department
$13,116.76
ASC (PI J8)
Ambulatory surgical center (freestanding)
$8,821.14

Common denial reasons

The recurring reasons claims for CPT 24579 get rejected.

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

  • Missing laterality modifier (LT or RT) — most commercial and Medicare plans reject elbow fracture claims without it
  • ICD-10 fracture code does not specify laterality or displacement status, creating a CPT-diagnosis mismatch
  • Global period conflict: post-op E/M billed without modifier 24 during the 90-day window gets automatically bundled
  • Upcoding concern when documentation does not support open treatment — payors audit for closed or percutaneous technique language in the op note
  • Modifier 22 appended without a separate supporting narrative explaining why work exceeded typical complexity

Frequently asked questions

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

01What is the difference between CPT 24579 and CPT 24582?
24579 is open treatment requiring an incision for direct fracture visualization and internal fixation. CPT 24582 covers percutaneous skeletal fixation of a humeral condylar fracture with manipulation — no open exposure. Use 24579 when you open the fracture site; use 24582 when pins are placed through the skin under fluoroscopic guidance without a formal incision.
02Do I need a laterality modifier on 24579?
Yes. Append LT or RT on every claim. Medicare and most commercial payers reject elbow fracture codes without a laterality modifier. Bilateral humeral condyle fractures are rare but would use modifier 50 with supporting documentation.
03Can I bill a post-op visit during the 90-day global period?
Routine post-op visits within the 90-day global are bundled — don't bill them separately. If you see the patient for a condition unrelated to the fracture repair during that window, bill the E/M with modifier 24 and document clearly that the visit addressed a separate problem.
04When is modifier 22 appropriate for 24579?
Modifier 22 applies when operative complexity substantially exceeds the typical case — for example, a comminuted condylar fracture with associated ligamentous disruption, prior hardware, or a morbidly obese patient requiring significantly extended operative time. Attach a written narrative to the claim; payors routinely deny modifier 22 without it.
05If the surgeon needs to return to the OR during the global period for elbow wound dehiscence, what modifier applies?
If the return procedure is related to the original fracture repair (e.g., irrigation and debridement of a wound complication), use modifier 78. If the return is for a completely unrelated procedure by the same surgeon during the 90-day global, use modifier 79. Do not invert these — modifier 79 on a related complication will incorrectly suggest the procedures share no clinical connection.
06Which ICD-10 codes pair with 24579?
Use fracture codes from the S42.4x series for distal humerus fractures, specifying lateral condyle (S42.42x) or medial condyle (S42.43x), laterality, displacement status, and encounter type (A for initial, S for sequela). A nonspecific or unilateral ICD-10 code paired with a laterality modifier that doesn't match is a common claim rejection trigger.

Mira AI Scribe

Mira's AI scribe captures condyle laterality (medial vs. lateral), approach name, fracture displacement and stability characterization, implants placed, and neurovascular exam findings from dictation. That prevents the two most common audit flags: an op note that says 'standard approach' and a claim with no laterality modifier — both of which trigger manual review or outright denial.

See how Mira captures CPT 24579 documentation

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