CPT code 24365: Radial head reconstruction, without prosthetic implant2026 Medicare rate & RVUs in Massachusetts
Report radial head reconstruction using the patient’s bone or graft material, rather than a prosthetic implant, to restore the damaged radial head.
CMS doesn’t publish an office rate for 24365 in Massachusetts.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 24365 covers
An orthopedic surgeon reconstructs the radial head, the upper end of the radius at the elbow, using native bone and, when needed, graft material. The operation may address a damaged or deficient radial head when reconstruction is chosen instead of prosthetic replacement. It is generally performed in an operating room, often in a hospital setting, and differs from treatment that fixes an acute fracture without reconstructing the radial head.
Report this code for reconstruction without a prosthetic implant; use the implant-specific sibling when an implant is used. The operative report should identify the reconstruction performed and whether graft material was used. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 24365 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | $662.04 |
| Rest of Massachusetts | Unavailable | $612.05 |
How the 24365 rate is calculated
Each of 24365’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 24365
RVUs × geographic indexes × conversion factor
Work8.40
8.40 RVUs× 1.000 GPCI
Practice expense7.95
7.95 RVUs× 1.000 GPCI
Malpractice1.78
1.78 RVUs× 1.000 GPCI
Adjusted RVUs
18.1300
Conversion factor
$33.4009
Medicare rate
$605.56
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 24365
24365 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24365
Radial head reconstruction, without prosthetic implant
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 24365
Radial head reconstruction, without prosthetic implant
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
24365 without 50 · national facility
$605.56
Radial head reconstruction, without prosthetic implant
24365-50 · Bilateral: 150%
$908.34
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
24365 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 24366Radial head arthroplastyWith prosthetic implant
- The key distinction is implant use: 24365 is reconstruction without a prosthetic implant, while 24366 is reconstruction with an implant.
- 24665Radial head surgeryWithout prosthetic replacement
- This code describes radial head reconstruction. Code 24665 is for open treatment of a radial head or neck fracture, including internal fixation or excision when performed.
- 24666Radial head surgeryWith prosthetic replacement
- Use 24666 for open treatment of a radial head or neck fracture with prosthetic replacement; 24365 describes reconstruction without a prosthetic implant.
24365 billing questions
How is this code distinguished from 24366?
Use 24365 for radial head reconstruction without a prosthetic implant, with or without graft material. Use 24366 when the reconstruction uses an implant.
Is graft material included in the code?
The reconstruction may include graft material. Documentation should describe the reconstruction and graft use; the code distinction from 24366 is whether a prosthetic implant is used.
Should this code be used for an acute radial head fracture?
Choose the fracture-treatment code that matches the operation when the surgeon treats an acute radial head or neck fracture. This code describes reconstruction of the radial head.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does CMS handle bilateral reporting and other procedures in the same session?
Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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