No office rate
Choose 24430 when the humeral nonunion or malunion is repaired without graft. Choose 24435 when autologous bone graft is part of the repair.
On this page
CMS RVU26D · Effective 2026-10-01
24435 Humerus repair Medicare reimbursement rates in Iowa
Reports operative repair of a humeral fracture nonunion or malunion when autologous bone graft is used to support reconstruction. Compare 24435 office and facility rates across CMS payment localities in Iowa.
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 24435 in Iowa?
Iowa 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
No supported rate
Facility setting
$907.43
1 of 1 localities have a supported rate.
Payment area: Iowa
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 surgery
About 24435: Humeral nonunion repair with autograft
Reports operative repair of a humeral fracture nonunion or malunion when autologous bone graft is used to support reconstruction.
An orthopedic surgeon uses this service to reconstruct a humerus that has failed to unite or has healed in a faulty position, adding the patient’s own bone graft to the repair. A typical case is a humeral fracture nonunion requiring graft augmentation; the graft may be taken from the iliac crest or another donor site. The service is generally performed in a hospital or ambulatory surgical setting, rather than as an office procedure.
Select this code when the operative repair includes autologous bone graft; use the related no-graft code when the repair does not. The operative report should establish the humeral nonunion or malunion, describe the reconstruction, and document use of autograft. The graft harvest is included in this service. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 24435
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.62 · 49%
- Practice expense (office) RVU12.39 · 41%
- Malpractice RVU3.05 · 10%
488
Medicare services in 2024 · #3588 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.
24435 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
24400 describes a humeral osteotomy, with or without internal fixation. It is not the grafted repair code for an established humeral nonunion or malunion.
No office rate
24420 is for humeral osteoplasty, such as a bone-shape or length procedure; 24435 is for repairing a humeral nonunion or malunion with autograft.
Compare 24435 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
Iowa →
Office / nonfacility
Unavailable
Facility
$907.43
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 24435 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,322
- Code
- 24435
- Physician work
- 14.62
- Practice expense
- 12.39
- Malpractice
- 3.05
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.62 | × 1.000 | 14.6200 |
| Practice expense | 12.39 | × 0.915 | 11.3369 |
| Malpractice | 3.05 | × 0.397 | 1.2108 |
| Total RVUs | 27.1677 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$907.43
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.62 | 1 |
| Practice expense | 12.39 | 0.915 |
| Malpractice | 3.05 | 0.397 |
(14.62 × 1 + 12.39 × 0.915 + 3.05 × 0.397) × $33.4009 = $907.43
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.
24435 billing questions
How does this differ from 24430?
Use 24435 when the humeral nonunion or malunion repair includes autologous bone graft. Code 24430 describes the corresponding repair without graft.
Is graft harvest separately reported?
The graft harvest is included when autologous bone is obtained for this repair. Do not separately report the harvest for the same graft.
What documentation supports this code?
The operative report should identify the humeral nonunion or malunion, describe the repair, and state that autologous bone graft was used. Document the graft source as part of the operative details.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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 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.
2,31924410,,Mlt osteot rlgnm imed rd hum,A,,14.73,11.39,NA,11.39,,3.13,29.25,29.25,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,32024420,,Osteoplasty humerus,A,,13.39,13.75,NA,13.75,,2.85,29.99,29.99,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,32124430,,Rpr non/mal humerus wo graft,A,,14.87,11.10,NA,11.10,,3.06,29.03,29.03,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,32224435,,Rpr non/mal hum with agrft,A,,14.62,12.39,NA,12.39,,3.05,30.06,30.06,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,32324470,,Hemiepiphyseal arrest,A,,8.71,8.56,NA,8.56,,1.85,19.12,19.12,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,32424495,,Decompression fasct forearm,A,,8.20,17.20,NA,17.20,,1.74,27.14,27.14,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,32524498,,Proph tx w/wo mthylmthcrylt,A,,11.97,9.53,NA,9.53,,2.52,24.02,24.02,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136