$440.40
24600 is for closed treatment of an elbow dislocation without anesthesia. Use 24640 when the diagnosis is radial head subluxation in a child.
On this page
CMS RVU26D · Effective 2026-10-01
24640 Nursemaid's elbow Medicare reimbursement rates in Kentucky
Reports manipulation to reduce a young child's radial head subluxation, commonly after traction on the arm, when the diagnosis is nursemaid's elbow. Compare 24640 office and facility rates across CMS payment localities in Kentucky.
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 24640 in Kentucky?
Kentucky 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
$97.23
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$68.13
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 procedure
About 24640: Closed reduction of nursemaid's elbow
Reports manipulation to reduce a young child's radial head subluxation, commonly after traction on the arm, when the diagnosis is nursemaid's elbow.
This service covers a clinician's manipulation to reduce radial head subluxation in a young child, commonly after an adult pulls or lifts the child by the hand or forearm. A pediatrician, emergency physician, or orthopedist may perform the reduction in an office or emergency department. Typical maneuvers involve rotating the forearm and flexing the elbow; the clinician assesses the child afterward for restored use of the arm.
Select this code when the documented condition is radial head subluxation and the clinician performs the reduction, rather than treating an elbow dislocation or fracture. Document the history and examination supporting the diagnosis, the manipulation performed, and the child's response. Related postoperative visits are included for 10 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 24640
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU1.22 · 39%
- Practice expense (office) RVU1.83 · 59%
- Malpractice RVU0.07 · 2%
15
Medicare services in 2024 · #6059 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.
24640 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
24605 addresses closed treatment of an elbow dislocation requiring anesthesia; 24640 is for manipulation of nursemaid's elbow.
$276.86
24650 is for a radial head or neck fracture treated without manipulation. Choose 24640 for radial head subluxation, not a fracture.
$491.19
24655 treats a radial head or neck fracture with manipulation. The diagnosis for 24640 is subluxation, not fracture.
Compare 24640 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
Kentucky →
Office / nonfacility
$97.23
Facility
$68.13
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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 24640 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,350
- Code
- 24640
- Physician work
- 1.22
- Practice expense
- 1.83
- Malpractice
- 0.07
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.22 | × 1.000 | 1.2200 |
| Practice expense | 1.83 | × 0.889 | 1.6269 |
| Malpractice | 0.07 | × 0.915 | 0.0641 |
| Total RVUs | 2.9109 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$97.23
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.22 | 1 |
| Practice expense | 1.83 | 0.889 |
| Malpractice | 0.07 | 0.915 |
(1.22 × 1 + 1.83 × 0.889 + 0.07 × 0.915) × $33.4009 = $97.23
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.22 | 1 |
| Practice expense | 0.85 | 0.889 |
| Malpractice | 0.07 | 0.915 |
(1.22 × 1 + 0.85 × 0.889 + 0.07 × 0.915) × $33.4009 = $68.13
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.
24640 billing questions
How is this different from an elbow dislocation code?
Use 24640 for radial head subluxation, commonly called nursemaid's elbow. Codes 24600 and 24605 describe closed treatment of an elbow dislocation, a different diagnosis.
Can this code be used for a radial head fracture?
No. For a radial head or neck fracture, select the fracture-treatment code that matches the treatment performed, such as 24650 or 24655.
Does the code include the reduction maneuver?
Yes. The manipulation to reduce the subluxation is the service represented by 24640; do not report a separate reduction code for that same maneuver.
What documentation supports reporting 24640?
Document findings consistent with radial head subluxation, the manipulation performed, and the child's response, such as return of comfortable arm use.
How does the 10-day global period affect follow-up?
Related postoperative visits during the 10-day global period are included in the procedure payment.
How is bilateral treatment reported?
For treatment of both elbows, modifier 50 is paid at 150% under the CMS bilateral rule supplied for this code.
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.
2,34724615,,Optx aqt/chrnc elbow dislc,A,,9.58,8.36,NA,8.36,,1.96,19.90,19.90,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,34824620,,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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631