Billing code 24538: Humerus fracture fixationMedicare rate & RVUs in Guam
Reports percutaneous skeletal fixation of a supracondylar or transcondylar humerus fracture, including fractures with intercondylar extension.
CMS doesn’t publish an office rate for 24538 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 24538 covers
An orthopedic surgeon uses this code when stabilizing a supracondylar or transcondylar fracture of the humerus with skeletal fixation placed through the skin. A typical situation is a displaced fracture near the elbow, often in a child, treated with reduction and percutaneous pins under imaging guidance. The fracture may have intercondylar extension; the code is specific to the supracondylar or transcondylar fracture pattern, not an epicondylar fracture.
Report the service based on the documented fracture location and the percutaneous fixation technique. The operative note should identify the fracture pattern and describe the reduction and fixation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For a bilateral procedure reported with modifier 50, payment is 150%. Assistant-at-surgery payment is restricted; 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.
24538 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $773.23 |
How the 24538 rate is calculated
Each of 24538’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 · 24538
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.53Practice expense 10.94Malpractice 2.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 24538
24538 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24538
Humerus fracture fixation
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 24538
Humerus fracture fixation
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
24538 without 50 · national facility
$751.85
Humerus fracture fixation
24538-50 · Bilateral: 150%
$1,127.78
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).
24538 compared with similar codes
Compare codes
24538 vs 24535 vs 24545 vs 24546 vs 24566: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 24535Fracture treatment
- 24535 is closed treatment with manipulation and does not describe percutaneous skeletal fixation. Use 24538 when fixation is placed percutaneously for the supracondylar or transcondylar fracture.
- 24545Humerus fracture repair
- 24545 describes open treatment of a supracondylar or transcondylar fracture without intercondylar extension. Code 24538 describes percutaneous skeletal fixation and includes fractures with or without that extension.
- 24546Distal humerus repair
- 24546 is open treatment when the fracture has intercondylar extension. Code 24538 applies when the fracture is treated with percutaneous skeletal fixation.
- 24566Epicondyle fixation
- 24566 is for percutaneous fixation of an epicondylar humerus fracture. Code 24538 is for a supracondylar or transcondylar fracture.
24538 billing questions
When is 24538 used instead of 24535?
Use 24538 when percutaneous skeletal fixation is performed for the supracondylar or transcondylar fracture. Code 24535 describes closed treatment with manipulation without this percutaneous fixation.
Does 24538 include reduction and pin fixation?
The code represents treatment with percutaneous skeletal fixation; reduction and placement of the fixation are part of that fracture treatment.
What documentation supports 24538?
Document the supracondylar or transcondylar fracture pattern, any intercondylar extension, and the percutaneous skeletal fixation performed.
What is the global period for 24538?
It has a 90-day global period, which includes the day-before preoperative visit and related postoperative care during the 90 days.
Can an assistant or co-surgeon be paid for 24538?
CMS restricts assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.
How is 24538 paid with other procedures in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 applies to a bilateral procedure, with payment at 150%.
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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