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CMS RVU26D · Effective 2026-10-01

24935 Amputation revision Medicare reimbursement rates in Illinois

Revision of an existing upper-arm amputation reshapes the residual limb when surgical correction is needed for problems such as a prominent bone or poor prosthetic fit. Compare 24935 office and facility rates across CMS payment localities in Illinois.

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 24935 in Illinois?

Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$1159.00–$1290.99

4 of 4 localities have a supported rate.

Lowest: Rest Of Illinois

Highest: Chicago

A spread of $131.99 per service.

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.

Find 24935 in your payment locality →

Where 24935 pays more and less in Illinois

Amputation surgery

About 24935: Upper-arm amputation revision

Revision of an existing upper-arm amputation reshapes the residual limb when surgical correction is needed for problems such as a prominent bone or poor prosthetic fit.

This operation revises an existing upper-arm amputation stump rather than removing the arm for the first time. The surgeon may reshape the residual limb’s bone or soft tissue to address a problem such as a painful prominence, impaired healing, or difficulty fitting a prosthesis. Orthopedic and other surgeons who manage limb loss may perform the procedure in an operating room, commonly in a hospital or ambulatory surgical setting.

Report the code when the operative service is a revision of an existing upper-arm amputation; document the prior amputation, the reason for revision, and the work performed on the residual limb. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. For bilateral reporting with modifier 50, payment is at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 24935

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
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU16.04 · 47%
  • Practice expense (office) RVU14.60 · 43%
  • Malpractice RVU3.41 · 10%

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.

24935 compared with similar codes

Office rates for Illinois, from the same CMS release.

24900

Upper arm amputation

Through the humerus

No office rate

Use 24900 for the upper-arm amputation itself. Use 24935 when the patient already has an upper-arm amputation and the operation revises that residual limb.

24925

Arm amputation

Re-amputation through humerus

No office rate

Both relate to surgery after upper-arm amputation, but 24935 identifies revision of an existing stump. Choose 24925 only when its specific service matches the operative report.

24940

Revision of upper arm

No office rate

This is a related upper-arm revision code. Compare its full current descriptor with the documented procedure before choosing between it and 24935.

Compare 24935 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.

4 of 4 payment localities

Office and facility base rates · shared scale starting at $0

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24935 billing questions

How does this differ from an initial upper-arm amputation?

This code is for revising an existing upper-arm amputation stump. An initial amputation, rather than correction of a prior stump, points to an amputation code such as 24900.

What documentation supports reporting this revision?

Document the prior upper-arm amputation, the clinical problem prompting surgery, and the specific revision work performed on the residual limb.

Are related postoperative visits separately reported?

Related postoperative care during the 90-day global period is included, along with the day-before preoperative visit.

How is the code handled when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.

Can modifier 50 be used for bilateral revisions?

Yes. CMS pays bilateral reporting with modifier 50 at 150%.

When is an assistant at surgery payable?

Payment for an assistant at surgery requires documentation of medical necessity. Co-surgeon and team-surgery payment 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 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.

RVUs for 24935PPRRVU2026_Oct_nonQPP.csv, line 2,365 (RVU26D)