Percutaneous skeletal fixation of a medial or lateral humeral condylar fracture, performed with manipulation.

Verified May 8, 2026 · 6 sources ↓

Medicare: $782.92
Total RVUs: 23.44
Global, days: 90
Region: Elbow

Drawn from CMSEmednyCgsmedicareEatonhand

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify fracture location as medial or lateral condyle — payer audits flag notes that only say 'elbow fracture'
Document that manipulation was performed; 24582 requires manipulation and is not correct for fractures treated without it
Identify the fixation hardware used (K-wire gauge and count, cannulated screw size) and confirm percutaneous placement
Include pre- and post-reduction imaging findings (fluoroscopy intraoperatively and final fixation confirmation)
Record the patient's age and clinical presentation — pediatric cases may require additional medical necessity documentation for facility setting
Note any associated injuries (e.g., ulnar nerve involvement, concurrent elbow dislocation) that may support additional codes

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 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 XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 24582 covers percutaneous fixation of a humeral condylar fracture — medial or lateral — where the surgeon manipulates the fracture and stabilizes it using percutaneously placed hardware (typically Kirschner wires or screws) without opening the fracture site. This is the minimally invasive counterpart to open fixation (24579). The procedure is common in pediatric lateral condyle fractures but applies to adult condylar fractures as well.

The 90-day global period covers all routine postoperative management through day 90, including hardware check visits, cast/splint changes, and suture removal. Anything unrelated to the condylar fracture during that window requires modifier 24 (E/M) or modifier 79 (unrelated surgical procedure). A return to the OR for a related complication — such as wire migration requiring revision — is modifier 78.

Site of service matters here. HOPD and ASC payments differ substantially (see Site of Service comparison table). Most elbow condylar fixations in adults occur in the hospital setting; pediatric cases frequently use ASC or HOPD. Confirm authorization and document medical necessity for the chosen setting.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	9.89
Practice expense RVU	11.45
Malpractice RVU	2.1
Total RVU	23.44
Medicare national rate	$782.92
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	$782.92
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI J8) Ambulatory surgical center (freestanding)	$4,717.30

Common denial reasons

The recurring reasons claims for CPT 24582 get rejected.

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

Fracture laterality not documented — payers require explicit 'medial' or 'lateral' condyle in the operative note
Manipulation not documented — without it, 24582 is not supportable; auditors will downcode or deny
Bundling conflict when imaging guidance (fluoroscopy) is billed separately without confirming it is not already integral to the procedure
Global period violation — E/M or follow-up visit billed without modifier 24 within the 90-day postoperative window
Wrong code selected — 24582 (percutaneous) versus 24579 (open with internal fixation) mismatch between the operative report and the code submitted

Frequently asked questions

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

01What is the difference between 24582 and 24579?

24579 is open treatment of a humeral condylar fracture with internal fixation — the fracture site is surgically exposed. 24582 is percutaneous fixation with manipulation, meaning hardware is placed through the skin without opening the fracture. Choose the code that matches the operative approach documented in your note.

02Can 24582 be billed bilaterally?

Bilateral humeral condylar fractures are rare but not impossible (e.g., high-energy trauma). If both elbows are treated in the same session, append modifier 50 and document each side's fracture and fixation separately in the operative note.

03Is fluoroscopic guidance separately billable with 24582?

Intraoperative fluoroscopy used for fracture reduction and fixation confirmation is generally considered integral to percutaneous fracture fixation and is not separately reportable. Confirm with your MAC before billing imaging guidance add-ons alongside 24582.

04How does the 90-day global period affect billing for hardware removal?

If K-wires or screws are removed within the 90-day global, that removal is included in the global and cannot be billed separately as a planned staged procedure. If removal is unplanned due to a complication (wire migration, infection), bill with modifier 78. If hardware removal occurs after the global period, bill the appropriate removal code without a modifier.

05Can an E/M visit be billed on the same day as 24582?

Only if the E/M addresses a separately identifiable problem unrelated to the condylar fracture. Append modifier 25 to the E/M code. Document the distinct reason for the visit clearly — a fracture-related discussion on the day of surgery is bundled into the procedure.

06What ICD-10 codes pair with 24582?

The most common diagnoses are lateral condyle fractures of the humerus (S42.43x codes) and medial condyle fractures (S42.44x codes). Laterality and fracture type (displaced vs. nondisplaced) are required for ICD-10 specificity. A mismatch between the ICD-10 laterality and the CPT modifier (LT/RT) is a common claim edit trigger.

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 condyle side (medial vs. lateral), confirmation that manipulation was performed, hardware type and placement method (percutaneous), and intraoperative fluoroscopy findings from the surgeon's dictation. This prevents the two most common denials for 24582: missing laterality and undocumented manipulation.

See how Mira captures CPT 24582 documentation