No office rate
Choose 24361 when the documented procedure replaces the distal humerus and proximal ulna. This code is for arthroplasty using an implant and allograft.
On this page
CMS RVU26D · Effective 2026-10-01
24363 Elbow arthroplasty Medicare reimbursement rates in Delaware
Reports elbow arthroplasty using a prosthetic implant and allograft when joint damage requires reconstruction with these specific materials. Compare 24363 office and facility rates across CMS payment localities in Delaware.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 24363 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1284.33
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 24363: Elbow arthroplasty with implant and allograft
Reports elbow arthroplasty using a prosthetic implant and allograft when joint damage requires reconstruction with these specific materials.
An orthopedic surgeon reconstructs the elbow joint with a prosthetic implant and donor allograft tissue. This approach may be used for substantial joint damage, including complex post-traumatic or degenerative destruction, when the operative plan calls for both materials. The procedure is generally performed in a hospital or ambulatory surgery setting; CMS recorded facility services for this code in 2024.
Report this code when the operative documentation supports elbow arthroplasty using both an implant and allograft, rather than a different reconstruction method. The note should identify the joint reconstruction, implanted prosthesis, and allograft used. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures reported with modifier 50, CMS pays at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 24363
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU21.45 · 55%
- Practice expense (office) RVU13.16 · 34%
- Malpractice RVU4.33 · 11%
725
Medicare services in 2024 · #3230 by national volume
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.
24363 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Code 24362 specifies an implant with fascia lata. This code specifies an implant with allograft.
No office rate
Code 24370 is for revision of an existing elbow reconstruction, not primary arthroplasty with implant and allograft.
Compare 24363 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
Unavailable
Facility
$1284.33
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 24363 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,313
- Code
- 24363
- Physician work
- 21.45
- Practice expense
- 13.16
- Malpractice
- 4.33
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.45 | × 1.005 | 21.5572 |
| Practice expense | 13.16 | × 0.988 | 13.0021 |
| Malpractice | 4.33 | × 0.899 | 3.8927 |
| Total RVUs | 38.4520 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$1284.33
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.45 | 1.005 |
| Practice expense | 13.16 | 0.988 |
| Malpractice | 4.33 | 0.899 |
(21.45 × 1.005 + 13.16 × 0.988 + 4.33 × 0.899) × $33.4009 = $1284.33
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
24363 billing questions
How is this code distinguished from 24361?
This code describes elbow arthroplasty using an implant and allograft. Code 24361 describes replacement involving the distal humerus and proximal ulna; choose based on the reconstruction documented in the operative report.
What documentation supports reporting this code?
The operative report should support arthroplasty of the elbow and identify both the prosthetic implant and allograft used in the reconstruction.
Does the 90-day global period include postoperative visits?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
CMS permits payment for an assistant at surgery for this procedure. Co-surgeon and team-surgery payment are not permitted.
How is a bilateral procedure paid?
When the procedure is performed bilaterally and reported with modifier 50, CMS pays at 150%.
Should this code be used for revision of a prior elbow reconstruction?
A revision procedure is distinct from primary arthroplasty with implant and allograft. Review the revision codes, including 24370, when the operation revises an existing elbow reconstruction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,31024360,,Reconstruct elbow joint,A,,12.35,10.11,NA,10.11,,2.62,25.08,25.08,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31124361,,Reconstruct elbow joint,A,,14.05,10.81,NA,10.81,,3.00,27.86,27.86,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31224362,,Reconstruct elbow joint,A,,14.94,11.10,NA,11.10,,3.18,29.22,29.22,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31324363,,Replace elbow joint,A,,21.45,13.16,NA,13.16,,4.33,38.94,38.94,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31424365,,Reconstruct head of radius,A,,8.40,7.95,NA,7.95,,1.78,18.13,18.13,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31524366,,Reconstruct head of radius,A,,9.13,8.04,NA,8.04,,1.85,19.02,19.02,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,31624370,,Revise reconst elbow joint,A,,22.96,13.65,NA,13.65,,4.61,41.22,41.22,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503