No office rate
The key distinction is implant use: 24365 is reconstruction without a prosthetic implant, while 24366 is reconstruction with an implant.
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CMS RVU26D · Effective 2026-10-01
24365 Radial head reconstruction Medicare reimbursement rates in Delaware
Report radial head reconstruction using the patient’s bone or graft material, rather than a prosthetic implant, to restore the damaged radial head. Compare 24365 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 24365 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
$597.77
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 24365: Radial head reconstruction without implant
Report radial head reconstruction using the patient’s bone or graft material, rather than a prosthetic implant, to restore the damaged radial head.
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.
CMS billing rules for 24365
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.40 · 46%
- Practice expense (office) RVU7.95 · 44%
- Malpractice RVU1.78 · 10%
89
Medicare services in 2024 · #4969 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.
24365 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
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.
No office rate
Use 24666 for open treatment of a radial head or neck fracture with prosthetic replacement; 24365 describes reconstruction without a prosthetic implant.
Compare 24365 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
$597.77
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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 24365 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,314
- Code
- 24365
- Physician work
- 8.40
- Practice expense
- 7.95
- Malpractice
- 1.78
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.40 | × 1.005 | 8.4420 |
| Practice expense | 7.95 | × 0.988 | 7.8546 |
| Malpractice | 1.78 | × 0.899 | 1.6002 |
| Total RVUs | 17.8968 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$597.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.4 | 1.005 |
| Practice expense | 7.95 | 0.988 |
| Malpractice | 1.78 | 0.899 |
(8.4 × 1.005 + 7.95 × 0.988 + 1.78 × 0.899) × $33.4009 = $597.77
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.
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 under the CMS rules provided.
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 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.
2,31124361,,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
2,31724371,,Revise reconst elbow joint,A,,26.81,14.88,NA,14.88,,5.36,47.05,47.05,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,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