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Billing code

F043A — Humeral shaft fracture – closed reduction

Humeral shaft fracture, closed

Bill F043 for closed (non-operative, including traction) reduction of a humeral shaft fracture; no reduction is F042 and open reduction is F044.

Watch for: Casts or splints applied in the first 2 weeks are included; if after-care goes to another physician, claim 75% of the fee.

Code

F043A

Description

Humeral shaft fracture – closed reduction

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Closed reduction of a humeral shaft fracture.

What it covers

F043 is closed reduction of a shaft fracture, in the Shoulder, Arm and Chest section (N26). No reduction is F042 and open reduction is F044 (N26).

Billing rules

• Closed reduction means reduction by non-operative methods, including traction (N1).
• 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).
• Repeat reductions of the same fracture or dislocation: claim the full fee for the final reduction and after-care; earlier reductions by the same surgeon are claimed at 85% (N2).
• Age premiums of 10% to 30% apply for patients under 16 (GP64).

Often billed with

• E555 rigid external fixation (+50% of the closed reduction fee) (N3).
• E544 cast bracing (+40%), not for prefabricated devices (N3).
• E569 percutaneous pinning (+50%) (N3).

Related codes: F042, F044, E555, E544, E569

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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