Billing code 24635: Monteggia repairMedicare rate & RVUs in Oregon
Reports operative treatment of a Monteggia injury, combining a proximal ulna fracture with radial head dislocation, when the fracture-dislocation is managed openly.
CMS doesn’t publish an office rate for 24635 in Oregon.
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 24635 covers
A Monteggia injury pairs a fracture of the proximal ulna with dislocation of the radial head. An orthopedic surgeon treats it through an open approach, reducing the fracture-dislocation and stabilizing the ulna with fixation when performed. These operations are generally done in a hospital or ambulatory surgery setting; the operative report should establish the injury pattern and describe the reduction and stabilization performed.
Select this code for open operative management of the Monteggia fracture-dislocation, rather than closed treatment of the same injury. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same 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 services may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 24635 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $662.44 |
| Rest Of Oregon | Unavailable | $621.52 |
How the 24635 rate is calculated
Each of 24635’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 · 24635
RVUs × geographic indexes × conversion factor
Work8.58
8.58 RVUs× 1.000 GPCI
Practice expense8.84
8.84 RVUs× 1.000 GPCI
Malpractice1.74
1.74 RVUs× 1.000 GPCI
Adjusted RVUs
19.1600
Conversion factor
$33.4009
Medicare rate
$639.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 24635
24635 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 24635
Monteggia repair
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 24635
Monteggia repair
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
24635 without 50 · national facility
$639.96
Monteggia repair
24635-50 · Bilateral: 150%
$959.94
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).
24635 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 24620Monteggia treatment
- Both concern a Monteggia fracture-dislocation. Choose 24620 for closed treatment; choose 24635 when the injury is managed through an open operation.
- 24615Elbow dislocation
- This code addresses open treatment of an elbow dislocation. A proximal ulna fracture with radial head dislocation identifies the Monteggia pattern addressed by 24635.
- 24685Ulna fracture repair
- This code is for open treatment of a proximal ulna fracture without the Monteggia fracture-dislocation pattern. The associated radial head dislocation distinguishes 24635.
- 24665Radial head surgery
- This code treats a radial head or neck fracture openly. A Monteggia injury instead centers on a proximal ulna fracture with radial head dislocation.
24635 billing questions
When should this code be used instead of 24620?
Use 24635 when the Monteggia fracture-dislocation is treated through an open operation. Code 24620 describes closed treatment of that injury.
Does the injury need both an ulna fracture and a radial head dislocation?
Yes. The defining pattern is a proximal ulna fracture associated with radial head dislocation; an isolated elbow dislocation or proximal ulna fracture is a different injury.
What documentation supports reporting 24635?
The record should identify the Monteggia fracture-dislocation and document the open reduction and operative management, including fixation performed when applicable.
How is the code handled when other procedures occur in the same session?
The highest-valued procedure is paid in full, with other procedures paid at 50% under the standard multiple procedure reduction. The 90-day global period includes related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How is bilateral surgery reported?
For bilateral procedures, modifier 50 is paid at 150%.
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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