$419.46
Use 24565 when manipulation is performed during closed treatment. Use 24560 when the fracture is treated closed without manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
24565 Fracture treatment Medicare reimbursement rates in Guam
Reports closed treatment of a humeral epicondylar fracture when the clinician manipulates the fracture to improve alignment without open exposure. Compare 24565 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 24565 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
$635.60
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$505.72
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 fracture care
About 24565: Closed reduction of humeral epicondylar fracture
Reports closed treatment of a humeral epicondylar fracture when the clinician manipulates the fracture to improve alignment without open exposure.
This code describes nonopen treatment of a fracture at a humeral epicondyle near the elbow, with the clinician manipulating the fracture to improve alignment. Orthopedic surgeons and other qualified clinicians may provide this care after elbow trauma, commonly in a hospital or other facility. The treatment may include immobilization after reduction, with post-manipulation assessment of alignment and neurovascular status.
Choose the code when the documented fracture is epicondylar and manipulation is performed as part of closed treatment. The record should identify the fracture site and describe the reduction and resulting alignment. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 bilateral reporting is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 24565
- 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 RVU5.64 · 31%
- Practice expense (office) RVU11.16 · 62%
- Malpractice RVU1.21 · 7%
36
Medicare services in 2024 · #5546 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.
24565 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
24566 describes percutaneous skeletal fixation, rather than closed treatment with manipulation alone.
No office rate
24575 applies when the humeral epicondylar fracture is treated open; 24565 is for closed treatment with manipulation.
$725.49
24535 is for a supracondylar humeral fracture treated closed with manipulation. 24565 is for a humeral epicondylar fracture.
Compare 24565 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
$635.60
Facility
$505.72
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 24565 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,336
- Code
- 24565
- Physician work
- 5.64
- Practice expense
- 11.16
- Malpractice
- 1.21
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.64 | × 1.000 | 5.6400 |
| Practice expense | 11.16 | × 1.137 | 12.6889 |
| Malpractice | 1.21 | × 0.579 | 0.7006 |
| Total RVUs | 19.0295 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$635.60
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.64 | 1 |
| Practice expense | 11.16 | 1.137 |
| Malpractice | 1.21 | 0.579 |
(5.64 × 1 + 11.16 × 1.137 + 1.21 × 0.579) × $33.4009 = $635.60
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.64 | 1 |
| Practice expense | 7.74 | 1.137 |
| Malpractice | 1.21 | 0.579 |
(5.64 × 1 + 7.74 × 1.137 + 1.21 × 0.579) × $33.4009 = $505.72
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.
24565 billing questions
How does this differ from code 24560?
Both describe closed treatment of a humeral epicondylar fracture. Use 24565 when the clinician manipulates the fracture; 24560 is for treatment without manipulation.
When would 24566 or 24575 be considered instead?
These codes describe different treatment methods for an epicondylar fracture: percutaneous skeletal fixation for 24566 and open treatment for 24575. The operative record should support the method performed.
What documentation supports reporting 24565?
Document the humeral epicondylar fracture, the manipulation performed to improve alignment, and the post-reduction findings. Include the treatment and immobilization plan.
How does the global period affect related visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures and bilateral treatment handled?
For procedures in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. CMS pays bilateral reporting with modifier 50 at 150%.
Can an assistant or co-surgeon be reported?
CMS does not pay assistant-at-surgery services 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 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.
2,33324545,,Optx hum fx wo ntrcndylr xtn,A,,12.82,10.27,NA,10.27,,2.67,25.76,25.76,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33424546,,Optx hum fx w/ntrcndylr xtn,A,,14.54,11.01,NA,11.01,,3.00,28.55,28.55,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33524560,,Cltx hum epcndylr fx wo mnpj,A,,2.91,8.17,,6.05,,0.62,11.70,9.58,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33624565,,Cltx hum epcndylr fx w/mnpj,A,,5.64,11.16,,7.74,,1.21,18.01,14.59,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33724566,,Prq skel fix epcndylr hum fx,A,,8.83,9.97,NA,9.97,,1.88,20.68,20.68,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33824575,,Optx humeral epcndylr fx,A,,9.47,9.39,NA,9.39,,1.94,20.80,20.80,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33924576,,Cltx humrl cndylr fx wo mnpj,A,,2.98,8.65,,6.49,,0.64,12.27,10.11,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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