No office rate
This code is for a sequestrum at the radial head or neck. Code 24134 identifies the shaft or distal humerus as the site.
On this page
CMS RVU26D · Effective 2026-10-01
24136 Bone sequestrectomy Medicare reimbursement rates in Guam
Reports surgical removal of a sequestrum from the radial head or neck, typically when devitalized bone is treated in a setting such as chronic osteomyelitis. Compare 24136 office and facility rates across CMS payment localities in Guam.
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 24136 in Guam?
Guam 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
$612.92
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 24136: Radial head or neck sequestrectomy
Reports surgical removal of a sequestrum from the radial head or neck, typically when devitalized bone is treated in a setting such as chronic osteomyelitis.
This service removes a sequestrum, or isolated devitalized bone, from the radial head or neck near the elbow. An orthopedic surgeon typically performs the operation when dead bone requires removal, often in the setting of chronic osteomyelitis. The operative work is specific to the radial head or neck; sequestra in other elbow-region bones belong to different site-specific codes.
Select the code when the operative report supports removal of a sequestrum at this site, rather than a broader partial bone excision or removal of the radial head. 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, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral surgery reported with modifier 50, payment is at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 24136
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.19 · 46%
- Practice expense (office) RVU8.05 · 45%
- Malpractice RVU1.74 · 10%
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.
24136 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
Use this code for a sequestrum at the radial head or neck; code 24138 is for the olecranon process.
No office rate
Code 24145 describes partial bone excision at the radial head or neck. Choose this code when the operative work specifically removes a sequestrum.
No office rate
Code 24130 is for excision of the radial head. This code is specific to sequestrum removal at the radial head or neck.
Compare 24136 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$612.92
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 24136 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,278
- Code
- 24136
- Physician work
- 8.19
- Practice expense
- 8.05
- Malpractice
- 1.74
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.19 | × 1.000 | 8.1900 |
| Practice expense | 8.05 | × 1.137 | 9.1529 |
| Malpractice | 1.74 | × 0.579 | 1.0075 |
| Total RVUs | 18.3503 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$612.92
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.19 | 1 |
| Practice expense | 8.05 | 1.137 |
| Malpractice | 1.74 | 0.579 |
(8.19 × 1 + 8.05 × 1.137 + 1.74 × 0.579) × $33.4009 = $612.92
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.
24136 billing questions
How does this differ from partial excision of the radial head or neck?
Use this code when the documented target is a sequestrum, or isolated devitalized bone. Partial excision describes a different bone-removal service and should not be selected solely because bone was removed.
When is radial head excision a better fit?
Radial head excision is the relevant comparison when the operation removes the radial head rather than specifically removing a sequestrum from the radial head or neck.
What documentation supports reporting this code?
The operative report should identify the radial head or neck as the site and describe removal of sequestrated bone. A diagnosis such as osteomyelitis may provide clinical context but does not replace documentation of the procedure performed.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard 50% multiple-procedure reduction.
How should bilateral procedures and surgical assistance be handled?
For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.
What care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
2,27524126,,Exc/crtg b1 cst/tum rds algr,A,,8.40,8.31,NA,8.31,,1.78,18.49,18.49,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,27624130,,Excision radial head,A,,6.26,7.04,NA,7.04,,1.23,14.53,14.53,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,27724134,,Sequestrectomy shft/dstl hum,A,,9.96,8.97,NA,8.97,,2.12,21.05,21.05,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,27824136,,Sequestrectomy radial h/n,A,,8.19,8.05,NA,8.05,,1.74,17.98,17.98,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,27924138,,Sequestrectomy olecrn proces,A,,8.29,9.74,NA,9.74,,1.76,19.79,19.79,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,28024140,,Partial exc bone humerus,A,,9.31,8.42,NA,8.42,,1.91,19.64,19.64,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,28124145,,Prtl exc bone radial h/n,A,,7.61,7.71,NA,7.71,,1.63,16.95,16.95,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014