Billing code 24620: Monteggia treatmentMedicare rate & RVUs in Guam
Reports closed treatment of an elbow Monteggia fracture-dislocation when the proximal ulna fracture and radial head dislocation are managed without manipulation.
CMS doesn’t publish an office rate for 24620 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 24620 covers
A Monteggia injury combines a proximal ulna fracture with dislocation of the radial head at the elbow. This code describes closed treatment when the provider manages the injury without manipulating the fracture or dislocation, typically with immobilization. Orthopedic surgeons commonly provide this care in a hospital or other facility setting; the diagnosis and treatment plan should identify the fracture-dislocation pattern and the nonoperative approach.
Select this code based on the documented Monteggia injury and the fact that no manipulation was performed. The record should support the fracture and radial head dislocation, the treatment provided, and the decision to manage the injury closed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 pays bilateral procedures at 150%. Assistant-at-surgery payment requires documented medical necessity; 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.
24620 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $585.62 |
How the 24620 rate is calculated
Each of 24620’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 · 24620
RVUs × geographic indexes × conversion factor
Work7.04
7.04 RVUs× 1.000 GPCI
Practice expense8.47
8.47 RVUs× 1.000 GPCI
Malpractice1.49
1.49 RVUs× 1.000 GPCI
Adjusted RVUs
17.0000
Conversion factor
$33.4009
Medicare rate
$567.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 24620
24620 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24620
Monteggia treatment
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 24620
Monteggia treatment
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
24620 without 50 · national facility
$567.82
Monteggia treatment
24620-50 · Bilateral: 150%
$851.73
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).
24620 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 24635Monteggia repair
- Both describe Monteggia fracture-dislocation care. Choose 24620 for closed treatment without manipulation; choose 24635 when the provider performs open treatment.
- 24670Fracture care
- This code is for closed treatment without manipulation of a proximal ulna fracture without a radial head dislocation. A documented Monteggia pattern points to 24620.
- 24675Fracture treatment
- This code describes closed treatment with manipulation of a proximal ulna fracture, not a Monteggia fracture-dislocation. The injury pattern and whether manipulation occurred distinguish the services.
- 24600Elbow reduction
- This code addresses closed treatment of an elbow dislocation without anesthesia, rather than a Monteggia fracture-dislocation involving a proximal ulna fracture.
24620 billing questions
When is 24620 appropriate instead of 24635?
Use 24620 for closed treatment without manipulation. Code 24635 describes open treatment of a Monteggia fracture-dislocation.
What injury pattern supports this code?
Documentation should establish a proximal ulna fracture with radial head dislocation at the elbow. An isolated proximal ulna fracture does not establish a Monteggia injury.
Does this code include manipulation?
No. This code is for closed treatment without manipulation; document the treatment performed so the absence of manipulation is clear.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other same-session procedures handled?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 pays bilateral procedures at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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 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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