Closed treatment of a proximal ulnar fracture — olecranon or coronoid process — requiring manual manipulation to restore alignment without surgical incision.

Verified May 8, 2026 · 6 sources ↓

Medicare: $516.71
Work RVU: 4.79
Global, days: 90
Region: Elbow

Drawn from CMSAAPCFindacodeMdclarityFastrvu

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 structure is fractured — olecranon process, coronoid process, or both — not just 'proximal ulna fracture'
Confirm the treatment was closed (no surgical incision, no internal fixation hardware placed)
Document that manipulation was performed and describe the technique and the pre- and post-reduction alignment
Record pre- and post-reduction imaging findings, including angulation, displacement, and articular congruity
Note sedation or anesthesia used, if any, and the setting in which reduction was performed
Document immobilization applied after reduction — splint type, position, and degree of elbow flexion

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 51 Multiple procedures 52 Reduced services 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 LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 24675 covers closed (non-operative) reduction of a fracture at the proximal ulna, specifically the olecranon or coronoid process, where manipulation is required to achieve acceptable alignment. The code is distinct from its paired code for treatment without manipulation, and it is explicitly not an open procedure — no internal fixation is included. If fixation hardware is placed or the fracture site is opened, a different code applies.

The 90-day global period means the surgery date plus all routine post-op management — splint checks, cast changes, x-ray interpretation tied to the fracture, and follow-up visits through day 90 — are bundled. Any E/M performed the day before or day of the procedure to make the decision to proceed requires modifier 57. Laterality modifiers LT or RT are expected on every claim.

Common clinical scenarios include displaced olecranon fractures managed with reduction and posterior splinting under sedation, and coronoid process fractures reduced in conjunction with elbow dislocation management. If the fracture was initially attempted closed but ultimately required open reduction, document the conversion clearly — billing 24675 for an encounter that resulted in open fixation is a significant audit target.

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 (4.79) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (15.47) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	4.79
Practice expense RVU	9.67
Malpractice RVU	1.01
Total RVU	15.47
Medicare national rate	$516.71
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	$516.71
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 24675 get rejected.

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

Missing laterality — claim submitted without LT or RT modifier
Upcoding audit: operative note describes open exposure or hardware placement, which is inconsistent with a closed treatment code
E/M billed same-day without modifier 57 (90-day global triggers modifier 57, not 25, for the pre-procedure decision visit)
ICD-10 diagnosis code does not specify proximal ulna — nonspecific ulnar fracture codes do not map cleanly to 24675
Duplicate claim or global period conflict — post-op visit billed within 90-day window without modifier 24 for an unrelated condition

Frequently asked questions

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

01What is the difference between CPT 24670 and CPT 24675?

CPT 24670 is closed treatment of a proximal ulnar fracture without manipulation. CPT 24675 is the same anatomical site but requires that the physician actively manipulates the fracture to restore alignment. If the fracture was non-displaced and only immobilization was applied, 24670 is correct. If reduction was attempted or achieved, use 24675.

02Does CPT 24675 include the post-reduction cast or splint application?

Yes. Immobilization applied immediately following closed fracture treatment is bundled into the fracture care code. Do not separately bill a casting or splinting code for the same encounter.

03Which modifier is required on the pre-procedure E/M for a 90-day global code?

Modifier 57 — not 25. Because 24675 carries a 90-day (major) global, the E/M where the decision to treat was made requires modifier 57. Modifier 25 applies when the global period is 0 or 10 days.

04Can 24675 be billed bilaterally?

Bilateral proximal ulnar fractures are exceedingly rare, but if both sides were treated, append modifier 50 and document each fracture and each manipulation separately. Most payers will require individual LT and RT line items rather than a single modifier 50 claim.

05If the closed reduction failed and the surgeon converted to open fixation in the same session, which code applies?

Bill the open treatment code, not 24675. Attempted closed reduction that converts to open fixation is reported with the open procedure code. Document the conversion explicitly in the operative note — audit teams look for this discrepancy.

06Is modifier 78 appropriate if the patient returns to the OR during the global period for loss of reduction?

Yes, if the patient returns for a related procedure — such as repeat manipulation or conversion to open fixation — during the 90-day global, append modifier 78 to the return procedure. Modifier 79 applies only to procedures unrelated to the original fracture.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the fracture location (olecranon vs. coronoid), confirmation of closed technique, manipulation method, sedation used, and pre- and post-reduction imaging findings directly from operative or procedure dictation. This prevents the most common audit flag on 24675 — a note that mentions hardware or an incision paired with a closed-treatment code — and ensures the laterality and fracture specificity needed for clean ICD-10 mapping are in the record before the claim is submitted.

See how Mira captures CPT 24675 documentation