$565.94
Both describe closed care of a radial head or neck fracture. Choose 24655 if the clinician manipulates the fracture; choose 24650 if treatment proceeds without repositioning.
On this page
CMS RVU26D · Effective 2026-10-01
24650 Radial fracture care Medicare reimbursement rates in Guam
Report this code when a clinician provides definitive nonsurgical care for a radial head or neck fracture without repositioning the bone. Compare 24650 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 24650 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
$324.25
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$275.26
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 24650: Closed treatment of radial head or neck fracture without manipulation
Report this code when a clinician provides definitive nonsurgical care for a radial head or neck fracture without repositioning the bone.
This service covers closed treatment of a fracture at the radial head or neck near the elbow when the clinician accepts the bone’s position without manipulation. An orthopedist or other treating clinician may provide this care in an office or facility setting, often using a sling or other support and arranging follow-up. A stable radial head fracture is a typical example. The distinction is whether the clinician takes responsibility for definitive fracture treatment, rather than providing temporary support before referral.
Report one service for the treated fracture and document the fracture location, the decision not to manipulate it, and the treatment plan. Medicare assigns a 90-day global period that 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 the others at 50%. Bilateral treatment reported with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 24650
- 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 RVU2.25 · 25%
- Practice expense (office) RVU6.33 · 70%
- Malpractice RVU0.45 · 5%
6K
Medicare services in 2024 · #1758 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.
24650 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
24665 is for open treatment of the radial head or neck fracture. Choose 24650 when treatment remains closed and requires no manipulation.
$360.75
Both involve closed fracture treatment without manipulation near the elbow. Choose by the fractured bone: 24650 for the radial head or neck, 24670 for the proximal ulna.
Compare 24650 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
$324.25
Facility
$275.26
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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 24650 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,351
- Code
- 24650
- Physician work
- 2.25
- Practice expense
- 6.33
- Malpractice
- 0.45
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.25 | × 1.000 | 2.2500 |
| Practice expense | 6.33 | × 1.137 | 7.1972 |
| Malpractice | 0.45 | × 0.579 | 0.2606 |
| Total RVUs | 9.7078 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$324.25
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.25 | 1 |
| Practice expense | 6.33 | 1.137 |
| Malpractice | 0.45 | 0.579 |
(2.25 × 1 + 6.33 × 1.137 + 0.45 × 0.579) × $33.4009 = $324.25
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.25 | 1 |
| Practice expense | 5.04 | 1.137 |
| Malpractice | 0.45 | 0.579 |
(2.25 × 1 + 5.04 × 1.137 + 0.45 × 0.579) × $33.4009 = $275.26
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.
24650 billing questions
When should 24655 be reported instead?
Use 24655 when closed treatment of the radial head or neck fracture requires manipulation to reposition the bone. Use 24650 when the clinician treats the fracture in its existing position.
Does a sling provided before referral support reporting 24650?
A temporary sling alone does not establish definitive fracture care. The record should show that the reporting clinician assumed responsibility for treating the radial head or neck fracture.
Are follow-up visits for the fracture separately reported?
Medicare includes 90 days of related postoperative care in this code’s global period, along with the day-before preoperative visit.
How is treatment of fractures on both sides reported?
Report bilateral treatment with modifier 50 when the requirements for bilateral reporting are met. Medicare pays this code at 150% when reported bilaterally.
What happens if another procedure is performed in the same session?
The standard multiple procedure reduction applies: Medicare pays the highest-valued procedure in full and other procedures at 50%.
Can an assistant, co-surgeon, or surgical team be reported for 24650?
Medicare does not pay an assistant at surgery 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.
2,34824620,,Cltx monteggia fx dislc elbw,A,,7.04,8.47,NA,8.47,,1.49,17.00,17.00,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,34924635,,Optx monteggia fx dislc elbw,A,,8.58,8.84,NA,8.84,,1.74,19.16,19.16,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,35024640,,Cltx rdl head sublxtj nrsemd,A,,1.22,1.83,,0.85,,0.07,3.12,2.14,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,35124650,,Cltx rdl head/nck fx wo mnpj,A,,2.25,6.33,,5.04,,0.45,9.03,7.74,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,35224655,,Cltx rdl head/nck fx w/mnpj,A,,4.50,10.42,,7.70,,1.03,15.95,13.23,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,35324665,,Optx radial head/neck fx,A,,8.15,8.84,NA,8.84,,1.64,18.63,18.63,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,35424666,,Optx radial head/nck fx rplc,A,,9.61,8.95,NA,8.95,,1.95,20.51,20.51,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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