Billing code 24430: Humerus repairMedicare rate & RVUs in Illinois
Reports operative repair of a humeral fracture that has failed to unite or healed in malalignment when the repair is performed without bone graft.
CMS doesn’t publish an office rate for 24430 in Illinois.
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 24430 covers
An orthopedic surgeon uses this service to address a humeral fracture that has not united or has healed in a position requiring correction. The operation repairs the nonunion or malunion without bone graft. These cases are typically performed in a hospital operating room or another surgical facility; Medicare’s 2024 claims data show facility services for this code.
Select this code when the operative indication is humeral nonunion or malunion and the repair is performed without graft. The record should establish the healing problem and describe the operative repair and graft use. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.
Where 24430 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,107.32 |
| East St. Louis | Unavailable | $1,043.61 |
| Rest Of Illinois | Unavailable | $994.92 |
| Suburban Chicago | Unavailable | $1,062.02 |
How the 24430 rate is calculated
Each of 24430’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 · 24430
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 14.87Practice expense 11.10Malpractice 3.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 24430
24430 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24430
Humerus repair
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 24430
Humerus repair
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
24430 without 50 · national facility
$969.63
Humerus repair
24430-50 · Bilateral: 150%
$1,454.45
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).
24430 compared with similar codes
Compare codes
24430 vs 24435 vs 24400 vs 24420: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 24435Humerus repair
- Both address humeral nonunion or malunion. Choose 24430 when repair is without bone graft and 24435 when bone graft is used.
- 24400Humerus osteotomy
- Code 24400 describes humeral osteotomy, with or without internal fixation. Code 24430 is for repair of a humeral nonunion or malunion.
- 24420Humerus osteoplasty
- Code 24420 describes humeral osteoplasty; 24430 identifies repair of a humeral fracture nonunion or malunion without graft.
24430 billing questions
How is this code distinguished from 24435?
Use 24430 for repair of a humeral nonunion or malunion without bone graft. Code 24435 is the related repair code when bone graft is used.
What documentation supports reporting this code?
Document the humeral nonunion or malunion, the reason operative repair is needed, and the repair performed. The operative report should support that no bone graft was used.
Does the code include postoperative care?
Its 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral repair reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and team surgery is 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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