No office rate
Both describe Monteggia fracture-dislocation care. Choose 24620 for closed treatment without manipulation; choose 24635 when the provider performs open treatment.
On this page
CMS RVU26D · Effective 2026-10-01
24620 Monteggia treatment Medicare reimbursement rates in Missouri
Reports closed treatment of an elbow Monteggia fracture-dislocation when the proximal ulna fracture and radial head dislocation are managed without manipulation. Compare 24620 office and facility rates across CMS payment localities in Missouri.
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 24620 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$527.48–$554.34
3 of 3 localities have a supported rate.
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.
Where 24620 pays more and less in Missouri
Orthopedic fracture care
About 24620: Closed Monteggia fracture-dislocation treatment
Reports closed treatment of an elbow Monteggia fracture-dislocation when the proximal ulna fracture and radial head dislocation are managed without manipulation.
A Monteggia injury combines a proximal ulna fracture with dislocation of the radial head at the elbow. This code describes closed treatment when the provider manages the injury without manipulating the fracture or dislocation, typically with immobilization. Orthopedic surgeons commonly provide this care in a hospital or other facility setting; the diagnosis and treatment plan should identify the fracture-dislocation pattern and the nonoperative approach.
Select this code based on the documented Monteggia injury and the fact that no manipulation was performed. The record should support the fracture and radial head dislocation, the treatment provided, and the decision to manage the injury closed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 pays bilateral procedures at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 24620
- 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 RVU7.04 · 41%
- Practice expense (office) RVU8.47 · 50%
- Malpractice RVU1.49 · 9%
62
Medicare services in 2024 · #5218 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.
24620 compared with similar codes
Office rates for Missouri, from the same CMS release.
$304.32–$325.62
This code is for closed treatment without manipulation of a proximal ulna fracture without a radial head dislocation. A documented Monteggia pattern points to 24620.
$471.26–$501.28
This code describes closed treatment with manipulation of a proximal ulna fracture, not a Monteggia fracture-dislocation. The injury pattern and whether manipulation occurred distinguish the services.
$434.31–$462.29
This code addresses closed treatment of an elbow dislocation without anesthesia, rather than a Monteggia fracture-dislocation involving a proximal ulna fracture.
Compare 24620 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$549.41
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$554.34
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$527.48
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24620 billing questions
When is 24620 appropriate instead of 24635?
Use 24620 for closed treatment without manipulation. Code 24635 describes open treatment of a Monteggia fracture-dislocation.
What injury pattern supports this code?
Documentation should establish a proximal ulna fracture with radial head dislocation at the elbow. An isolated proximal ulna fracture does not establish a Monteggia injury.
Does this code include manipulation?
No. This code is for closed treatment without manipulation; document the treatment performed so the absence of manipulation is clear.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other same-session procedures handled?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 pays bilateral procedures at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are 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.
2,34524600,,Tx clsd elbow dislc w/o anes,A,,4.26,8.99,,6.76,,1.02,14.27,12.04,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,34624605,,Tx clsd elbow dislc req anes,A,,5.50,7.65,NA,7.65,,1.20,14.35,14.35,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,34724615,,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