Billing code 24931: Upper-arm amputationMedicare rate & RVUs in Illinois
Reports amputation through the upper arm when the surgeon places a prosthetic implant immediately as part of the same operative procedure.
CMS doesn’t publish an office rate for 24931 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 24931 covers
This service combines removal of the arm through the humerus with immediate placement of a prosthetic implant. It may be performed by an orthopedic or other surgeon treating an upper-extremity condition that requires amputation and allows immediate implant placement. The operative report should make clear that the implant was placed during the amputation procedure, rather than fitted later as a separate prosthetic service.
Select this code from the documented amputation level and operative technique, including immediate implant placement. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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.
Where 24931 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 | $983.02 |
| East St. Louis | Unavailable | $926.01 |
| Rest Of Illinois | Unavailable | $881.84 |
| Suburban Chicago | Unavailable | $941.66 |
How the 24931 rate is calculated
Each of 24931’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 · 24931
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.10Practice expense 9.81Malpractice 2.78
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 24931
24931 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24931
Upper-arm amputation
| 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) | 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 · 24931
Upper-arm amputation
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
24931 without 50 · national facility
$858.07
Upper-arm amputation
24931-50 · Bilateral: 150%
$1,287.11
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).
24931 compared with similar codes
Compare codes
24931 vs 24900 vs 24920 vs 24935 vs 24940: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 24900Upper arm amputation
- Use 24931 when the amputation includes immediate prosthetic implant placement. For another upper-arm amputation technique, compare the operative report with the specific listed code.
- 24920Upper-arm amputation
- Both concern upper-arm amputation, but 24931 specifically includes immediate prosthetic implant placement. Choose based on the documented procedure, not simply the diagnosis.
- 24935Amputation revision
- This code is for revision of an existing amputation, rather than the primary upper-arm amputation with immediate implant represented by 24931.
- 24940Revision of upper arm
- This is a revision procedure for an upper-arm amputation. Use 24931 for the primary amputation with immediate prosthetic implant placement when the operative details support it.
24931 billing questions
What distinguishes this code from other upper-arm amputation codes?
The operative report must support amputation through the humerus with immediate placement of a prosthetic implant. Compare the documented technique with the applicable neighboring amputation code before selecting the code.
What documentation supports reporting this code?
Document the amputation level, operative technique, and placement of the prosthetic implant during the same procedure. A later prosthetic fitting alone does not establish that the immediate-implant service was performed.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
How does the multiple-procedure rule affect payment?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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