24666 Radial head surgery Medicare reimbursement rates in Pennsylvania

This code describes open treatment of a radial head or neck fracture that includes replacement of the radial head with a prosthesis. An orthopedic surgeon typically performs the operation in a hospital or ambulatory surgery center, using an open approach to address the fracture and place the replacement. It is generally selected when the radial head cannot be adequately reconstructed, such as with a severely comminuted fracture. The service is distinct from open fracture treatment without prosthetic replacement.

Report the code when the operative record supports open treatment and radial head prosthetic replacement; documentation should identify the fracture and describe the procedure performed. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 applies to bilateral procedures, paid at 150%. Assistant-at-surgery services may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.