Billing code
F042A — Humeral shaft fracture – no reduction
Humeral shaft fracture, no reduction
Bill for definitive treatment of a humeral shaft fracture without reduction.
Watch for: The first external support is included, and a cast in the first 2 weeks isn't billed separately.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $67.80 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- F042A
- Description
- Humeral shaft fracture – no reduction
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Apr 1, 2025
- Termination date
- No end date
Explanation
Updated October 26, 2026
Treatment of a humeral shaft fracture without reduction.
What it covers
F042 is definitive treatment of a shaft fracture without reduction, in the Shoulder, Arm and Chest section (N26). Closed reduction is F043 and open reduction is F044 (N26).
Billing rules
- No reduction means definitive treatment by any other method, and includes the first external support other than a simple splint (N1).
- If the case was referred and this fee is lower than the surgical consultation fee, you may claim the consultation amount under this procedure code instead, with no other claims for the care (SP4).
- The major pre-operative visit (the consultation or assessment where you decide to treat) may be billed in addition to the fracture or dislocation fee (N1, SP2).
- Multiple fractures or dislocations: the major one is paid at 100% and each other one at 85% (N1).
- If after-care is transferred to another physician, you claim 75% of the fee and the receiving surgeon bills visits (N2).
- Plaster casts or corrective splints applied at surgery or in the first 2 weeks are not billed separately when a fracture or dislocation fee applies (N7).
- Non-elective and started after hours: add E409 (+50%, weekday evenings and weekend/holiday days and evenings) or E410 (+75%, nights 00:00–07:00) (GP103–GP104, SP2).
- Age premiums of 10% to 30% apply for patients under 16 (GP64).
Related codes: F043, F044, F053, F047
Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Shoulder, Arm and Chest, page N26. Fracture and dislocation rules N1–N2.
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