Humeral shaft fractures account for 3% of managed fractures. Historically, in the absence of neurovascular injury, open fracture, or polytrauma they have been managed non-operatively with functional bracing. An upward trend in operative fixation rates has recently emerged. Operative fixation techniques for the humeral shaft include open reduction and internal fixation (ORIF) and intramedullary nailing (IM). Although numerous studies have compared outcomes of these treatment modalities, there is no consensus on the ideal approach for isolated fractures. Moreover, no investigation has applied a value-based lens to differentiate the cost-effectiveness of these treatments, an increasingly pertinent consideration with U.S. healthcare spending surpassing $3.2 trillion annually. Thus, the present study applies a decision tree model to investigate the value of operative treatment for humeral shaft fracture with ORIF or IM approaches, in comparison to functional bracing.