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CPT code 24655: Fracture reduction, with manipulation2026 Medicare rate & RVUs in Puerto Rico

Reports closed treatment of a radial head or neck fracture when the physician manipulates the fracture to correct its position.

CMS RVU26DEffective Oct 1, 2026One payment locality303 Medicare services in 2024

In Puerto Rico, Medicare pays $536.06 for 24655 in the office and $444.21 when it’s performed in a hospital or facility.

$536.06Office (non-facility)
$444.21Hospital or facility
+0.6%vs the national office rate ($532.74)

Check a contract rate as a % of Medicare · 24655 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 24655 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 24655 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 24655 covers

This service covers treatment of a radial head or neck fracture at the elbow without surgically exposing the fracture. The physician manually manipulates the bone to improve alignment and may immobilize the arm in a splint or cast. It is commonly performed by an orthopedic surgeon in an office, emergency department, or procedure setting when closed reduction is appropriate.

Report this code when documentation supports both the fracture site and the manipulation performed; closed fracture care without manipulation is reported with a different code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and others at 50%. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are 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.

How Puerto Rico compares for 24655

Across 109 of 109 payment localities, the office rate for 24655 runs from $466.99 in Arkansas to $687.15 in San Benito County, CA. Puerto Rico pays $536.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

24655 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$536.06
  2. Los Angeles, CA · California$591.04+$54.98
  3. Washington, DC area · District of Columbia$606.70+$70.64
  4. Miami, FL · Florida$599.62+$63.56
  5. Chicago, IL · Illinois$580.09+$44.03
  6. Manhattan, NY · New York$618.91+$82.85
  7. Alaska · Alaska$615.07+$79.01

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

24655 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$474.31$394.81
ArkansasArkansas$466.99$388.95
ArizonaArizona$517.00$428.97
Bakersfield, CACalifornia$555.56$455.99
Chico, CACalifornia$552.75$453.18
El Centro, CACalifornia$552.92$453.35
Fresno, CACalifornia$552.75$453.18
Hanford, CACalifornia$552.75$453.18

24655 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$466.99

$619.95

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
24655 office rate range by state
State / territoryOffice rate rangeLocalities
AK$615.071
AL$474.311
AR$466.991
AZ$517.001
CA$552.75–$687.1529
CO$549.291
CT$569.771
DC$606.701
DE$525.841
FL$534.74–$599.623
GA$501.76–$545.682
GU$565.941
HI$565.941
IA$482.421
ID$486.771
IL$521.83–$580.094
IN$489.651
KS$482.271
KY$491.191
LA$491.28–$516.892
MA$546.61–$602.642
MD$535.60–$606.703
ME$491.90–$516.922
MI$506.90–$544.162
MN$518.621
MO$483.82–$516.113
MS$475.391
MT$532.681
NC$497.011
ND$512.311
NE$484.551
NH$542.711
NJ$574.11–$600.242
NM$510.771
NV$527.351
NY$505.12–$637.635
OH$502.741
OK$487.831
OR$521.13–$564.972
PA$502.31–$556.362
PR$536.061
RI$543.371
SC$501.131
SD$509.901
TN$485.141
TX$498.98–$549.318
UT$508.351
VA$516.71–$606.702
VI$536.061
VT$512.271
WA$544.92–$612.972
WI$494.321
WV$501.981
WY$523.801

See 24655 in every payment locality

How the 24655 rate is calculated

Each of 24655’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 · 24655

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.50

4.50 RVUs× 1.000 GPCI

Practice expense10.42

10.42 RVUs× 1.000 GPCI

Malpractice1.03

1.03 RVUs× 1.000 GPCI

Adjusted RVUs

15.9500

Conversion factor

$33.4009

Medicare rate

$532.74

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,352

Code
24655
Physician work
4.50
Practice expense
10.42
Malpractice
1.03

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 24655 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work4.50× 1.0004.5000
Practice expense10.42× 1.01110.5346
Malpractice1.03× 0.9851.0146
Total RVUs16.0492
Conversion factor× 33.4009

Office rate, Puerto Rico$536.06

Office: (4.5 × 1 + 10.42 × 1.011 + 1.03 × 0.985) × $33.4009 = $536.06

Facility: (4.5 × 1 + 7.7 × 1.011 + 1.03 × 0.985) × $33.4009 = $444.21

Open 24655 in the RVU calculator

Payment rules and modifiers for 24655

24655 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 24655

Fracture reduction, with manipulation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 24655

Fracture reduction, with manipulation

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

24655 without 50 · national office

$532.74

Fracture reduction, with manipulation

24655-50 · Bilateral: 150%

$799.11

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).

When to use modifier 50

Codes related to 24655

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 24655
CodeHow it relatesOffice range, Puerto Rico
Same family
24650Radial fracture care, head or neck, no manipulationClosed radial head or neck fracture treatment without manipulation.$303.71
Used instead
24665Radial head surgery, without prosthetic replacementOpen treatment is used when the fracture requires operative exposure rather than closed manipulation.No office rate
24666Radial head surgery, with prosthetic replacementUsed for operative treatment involving replacement of the radial head.No office rate

How 24655 has changed in Puerto Rico

24655 · Office / nonfacility

$536.06

Effective 2026-10-01

The base rate is $77.59 higher than on 2025-10-01, moving from $458.47 to $536.06 (16.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $458.47changed to$536.06

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.62 changed to 4.50
    • Practice expense RVU 8.59 changed to 10.42
    • Malpractice RVU 0.92 changed to 1.03
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $469.43changed to$458.47

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.49 changed to 8.59
    • Malpractice RVU 0.95 changed to 0.92

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $461.77changed to$469.43

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $467.68changed to$461.77

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.22 changed to 8.49
    • Malpractice RVU 0.91 changed to 0.95
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $465.95changed to$467.68

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $467.19changed to$465.95

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.90 changed to 8.22
    • Malpractice RVU 0.93 changed to 0.91
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $461.93changed to$467.19

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.66 changed to 7.90
    • Malpractice RVU 0.91 changed to 0.93

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $459.30changed to$461.93

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.17 changed to 7.66
    • Malpractice RVU 0.89 changed to 0.91
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $457.79changed to$459.30

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.23 changed to 7.17
    • Malpractice RVU 0.81 changed to 0.89
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $453.30changed to$457.79

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.12 changed to 7.23

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $398.59changed to$453.30

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.97 changed to 7.12
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $349.20changed to$398.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.94 changed to 6.97
    • Malpractice RVU 0.82 changed to 0.81
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $350.56changed to$349.20

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.83 changed to 0.82

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $348.82changed to$350.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $346.00changed to$348.82

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.96 changed to 6.94
    • Malpractice RVU 0.82 changed to 0.83
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $341.86changed to$346.00

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.69 changed to 6.96
    • Malpractice RVU 0.86 changed to 0.82
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $341.86

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$536.06$444.21RVU26D
2026-07-01$536.06$444.21RVU26C
2026-04-01$536.06$444.21RVU26B
2026-01-01$536.06$444.21RVU26A
2025-10-01$458.47$412.54RVU25D
2025-07-01$458.47$412.54RVU25C
2025-04-01$458.47$412.54RVU25B
2025-01-01$458.47$412.54RVU25A
2024-10-01$469.43$422.50RVU24D
2024-07-01$469.43$422.50RVU24C
2024-04-01$469.43$422.50RVU24B
2024-03-09$469.43$422.50RVU24AR
2024-01-01$461.77$415.61RVU24A
2023-10-01$467.68$421.23RVU23D
2023-07-01$465.95$419.86RVU23C
2023-04-01$465.95$419.86RVU23B
2023-01-01$465.95$419.86RVU23A
2022-10-01$467.19$421.14RVU22D
2022-07-01$467.19$421.14RVU22C
2022-04-01$467.19$421.14RVU22B
2022-01-01$467.19$421.14RVU22A
2021-10-01$461.93$416.56RVU21D
2021-07-01$461.93$416.56RVU21C
2021-04-01$461.93$416.56RVU21B
2021-01-01$461.93$416.56RVU21A
2020-10-01$459.30$415.65RVU20D
2020-07-01$459.30$415.65RVU20C
2020-04-01$459.30$415.65RVU20B
2020-01-01$459.30$415.65RVU20A
2019-10-01$457.79$414.60RVU19D
2019-07-01$457.79$414.60RVU19C
2019-04-01$457.79$414.60RVU19B
2019-01-01$457.79$414.60RVU19A
2018-10-01$453.30$411.25RVU18D
2018-07-01$453.30$411.25RVU18C
2018-04-01$453.30$411.25RVU18B
2018-01-01$453.30$411.25RVU18AR1
2017-10-01$398.59$364.80RVU17D
2017-07-01$398.59$364.80RVU17C
2017-04-01$398.59$364.80RVU17B
2017-01-01$398.59$364.80RVU17A
2016-10-01$349.20$321.68RVU16D
2016-07-01$349.20$321.68RVU16C
2016-04-01$349.20$321.68RVU16B
2016-01-01$349.20$321.68RVU16A
2015-10-01$350.56$322.44RVU15D
2015-07-01$350.56$322.44RVU15C
2015-04-01$348.82$320.84RVU15B
2015-01-01$348.82$320.84RVU15A
2014-10-01$346.00$319.22RVU14D
2014-07-01$346.00$319.22RVU14C
2014-04-01$346.00$319.22RVU14B
2014-01-01$346.00$319.22RVU14A
2013-10-01$341.86$313.95RVU13D
2013-07-01$341.86$313.95RVU13C
2013-04-01$341.86$313.95RVU13B
2013-01-01$341.86$313.95RVU13AR

Price 24655 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

24655 billing questions

How does this differ from 24650?

Use 24655 when the physician manipulates the radial head or neck fracture to improve alignment. Code 24650 describes closed treatment without manipulation.

What documentation supports reporting manipulation?

Document the radial head or neck fracture and the physician's manipulation or reduction of the fracture. A note describing immobilization alone does not establish that manipulation was performed.

Can fracture immobilization be separately reported?

The code describes closed fracture treatment that includes manipulation. Do not report the same fracture-care work again as a separate service.

How should bilateral radial fractures be reported?

For bilateral treatment, report modifier 50; Medicare pays the bilateral procedure at 150%.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, Medicare pays the highest-valued procedure in full and the other procedure or procedures at 50%.

Can an assistant or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

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
RVUs for 24655PPRRVU2026_Oct_nonQPP.csv, line 2,352 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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