Fracture care · Elbow

24670

Closed treatment of a proximal ulna fracture without manipulation, managed with splinting or casting at the elbow level.

Verified May 8, 2026 · 5 sources ↓

Medicare
$336.68
Total RVUs
10.08
Global, days
90
Region
Elbow
Drawn from CMSAAOSAAPCMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

  • Imaging (X-ray or CT) confirming proximal ulna fracture location and acceptable alignment without manipulation
  • Explicit statement that no manipulation was performed at the time of treatment
  • Description of immobilization applied — splint type, material, and anatomic placement
  • Neurovascular status of the affected extremity documented before and after immobilization
  • Mechanism of injury and clinical presentation supporting fracture diagnosis
  • Plan for follow-up imaging and fracture reassessment within the 90-day global

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 52 Reduced services 57 Decision for surgery 58 Staged or related 76 Repeat, same physician 77 Repeat, another physician 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 24670 covers closed (non-operative) treatment of a proximal ulnar fracture — the near-elbow end of the ulna — where no bone manipulation is performed. The fracture is stabilized with a splint or cast to maintain position while healing proceeds. Because no manipulation occurs, this code is reserved for fractures already in acceptable alignment at the time of evaluation.

The 90-day global period applies. That window covers the initial treatment visit, the procedure itself, and all routine fracture follow-up through day 90 — cast checks, splint adjustments, and standard healing assessments. Any unrelated E/M service during the global requires modifier 24. If the treating physician decides surgery is warranted at the initial visit and that visit is the decision-for-surgery encounter, modifier 57 applies to the E/M.

Distinguish 24670 from 24675 (closed treatment with manipulation) and from open treatment codes 24685/24686. Billing the wrong variant is a common audit flag. Radiographic findings documenting acceptable alignment without need for reduction are the evidentiary backbone of 24670.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU2.62
Practice expense RVU6.92
Malpractice RVU0.54
Total RVU10.08
Medicare national rate$336.68
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
$336.68
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 24670 get rejected.

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

  • Code billed as 24670 when operative notes or visit records indicate manipulation was performed — should be 24675
  • Separate E/M billed on the same day without modifier 25, triggering bundling denial
  • Radiologic supervision/interpretation billed separately when imaging review is integral to fracture management at the same encounter
  • ICD-10 diagnosis code does not specify proximal ulna or laterality, creating a mismatch with the procedure code
  • Routine follow-up visits billed separately during the 90-day global period without modifier 24 for unrelated conditions

Frequently asked questions

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

01What separates 24670 from 24675?
24670 is closed treatment without manipulation — the fracture is in acceptable alignment and only immobilization is applied. 24675 is closed treatment with manipulation, meaning the physician actively reduces the fracture. Billing 24670 when the note describes any reduction attempt will trigger a downcoding or denial on audit.
02Can I bill a separate E/M on the same day as 24670?
Yes, but only if the E/M addresses a significant, separately identifiable service beyond the fracture evaluation itself. Append modifier 25 to the E/M. Without modifier 25, payers will bundle it into the fracture care code.
03Does the 90-day global include the cast or splint changes?
Yes. Routine cast checks, splint modifications, and standard fracture follow-up visits are all included in the 90-day global. Bill them separately only if the visit is unrelated to the fracture — and in that case, append modifier 24 to the E/M.
04When does modifier 57 apply to the E/M visit for this code?
Modifier 57 applies to the E/M when the decision for surgery is made at that encounter and the procedure has a 90-day global period. If the initial evaluation results in a decision to treat with closed management (non-surgical), modifier 57 is not relevant — it's a surgical decision modifier.
05How should laterality be reported for 24670?
Use modifier LT or RT to specify the treated side. If a Medicare claim is submitted, bilateral fracture treatment on the same date should be reported on two separate claim lines with LT and RT. For ASC billing, CMS requires two claim lines with LT and RT rather than modifier 50.
06Is fluoroscopic guidance separately billable with 24670?
Generally no. Per NCCI policy, radiologic guidance integral to the fracture management procedure is not separately reportable at the same encounter. If imaging is performed as a distinct, separately indicated study, document the separate clinical indication clearly.
07What if the fracture subsequently requires surgery during the global period?
If the same physician performs the subsequent open or operative treatment, use modifier 58 (staged or related procedure) if the need for surgery was anticipated, or modifier 78 (unplanned return for a related procedure) if it was not. Modifier 58 resets the global clock; modifier 78 does not.

Sources & references

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

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    cms.gov
    https://www.cms.gov/files/document/04-chapter4-ncci-medicare-policy-manual-2026-final.pdf
  3. 03
    aaos.org
    https://www.aaos.org/globalassets/quality-and-practice-resources/coding-and-reimbursement/resident-guide/resident-guide_modifiers.pdf
  4. 04
    aapc.com
    https://www.aapc.com/codes/cpt-codes/24670
  5. 05
    mdclarity.com
    https://www.mdclarity.com/cpt-code/24670

Mira AI Scribe

Mira's AI scribe captures fracture location (proximal ulna), confirmation that no reduction or manipulation was performed, immobilization type and application, and neurovascular exam findings — all from dictation. This prevents the most common audit flag: operative or visit notes that fail to explicitly state manipulation was not attempted, leaving coders unable to defend 24670 over 24675.

See how Mira captures CPT 24670 documentation

Related CPT codes

24620 $567.82
Closed treatment of a Monteggia fracture-dislocation at the elbow — proximal ulna fracture combined with radial head dislocation — performed with manipulation and without surgical incision.
28575 $422.52
Closed treatment of a talotarsal joint dislocation performed under anesthesia — meaning the dislocated joint between the talus and an adjacent tarsal bone is manually reduced without surgical opening, but anesthesia is required to achieve it.
26676 $488.99
Percutaneous pin fixation of a non-thumb carpometacarpal dislocation, with closed manipulation, billed per joint treated.
29834 $468.61
Arthroscopic surgical procedure on the elbow involving removal of a loose body or foreign body through the arthroscope, requiring either a separate incision or enlarged portal when the fragment equals or exceeds the cannula diameter.
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