$613.07
Both codes concern closed treatment of a humeral epicondyle fracture. Choose 24565 when manipulation is performed; choose 24560 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
24560 Fracture treatment Medicare reimbursement rates in Rhode Island
Reports closed care of a humeral epicondyle fracture managed without manipulation, such as immobilization and ongoing fracture management by the treating clinician. Compare 24560 office and facility rates across CMS payment localities in Rhode Island.
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 24560 in Rhode Island?
Rhode Island 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
$399.41
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$326.26
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 24560: Closed humeral epicondyle fracture treatment
Reports closed care of a humeral epicondyle fracture managed without manipulation, such as immobilization and ongoing fracture management by the treating clinician.
This code describes closed management of a fracture at a humeral epicondyle near the elbow when the clinician treats the fracture without manipulating the fragments. Care may include immobilization in a cast or splint and the physician’s management of healing. Orthopedic surgeons and other clinicians qualified to manage fractures may provide this service in an office, emergency department, or hospital setting. The fracture must involve an epicondyle of the humerus; a supracondylar or condylar fracture is a different location.
Choose this code when the documented treatment does not involve manipulation, percutaneous skeletal fixation, or open treatment. The record should identify the fracture site and support the closed treatment provided. Medicare assigns a 90-day global period, which 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 other procedures are subject to the standard 50% reduction. For bilateral treatment reported with modifier 50, payment is at 150%. Medicare does not pay for an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 24560
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.91 · 25%
- Practice expense (office) RVU8.17 · 70%
- Malpractice RVU0.62 · 5%
325
Medicare services in 2024 · #3933 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.
24560 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
24566 describes percutaneous skeletal fixation of the epicondylar fracture, unlike 24560, which is closed treatment without manipulation or percutaneous fixation.
No office rate
24575 is for open treatment of the humeral epicondyle fracture. Use 24560 for closed care without manipulation.
$443.33
24530 concerns a supracondylar humeral fracture, above the condyles. Code 24560 is for a fracture at a humeral epicondyle.
Compare 24560 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
Rhode Island →
Office / nonfacility
$399.41
Facility
$326.26
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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 24560 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,335
- Code
- 24560
- Physician work
- 2.91
- Practice expense
- 8.17
- Malpractice
- 0.62
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.91 | × 1.019 | 2.9653 |
| Practice expense | 8.17 | × 1.033 | 8.4396 |
| Malpractice | 0.62 | × 0.892 | 0.5530 |
| Total RVUs | 11.9579 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$399.41
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.91 | 1.019 |
| Practice expense | 8.17 | 1.033 |
| Malpractice | 0.62 | 0.892 |
(2.91 × 1.019 + 8.17 × 1.033 + 0.62 × 0.892) × $33.4009 = $399.41
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.91 | 1.019 |
| Practice expense | 6.05 | 1.033 |
| Malpractice | 0.62 | 0.892 |
(2.91 × 1.019 + 6.05 × 1.033 + 0.62 × 0.892) × $33.4009 = $326.26
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.
24560 billing questions
When should 24560 be chosen instead of 24565?
Use 24560 when the humeral epicondyle fracture is treated without manipulation. Use 24565 when the clinician manipulates the fracture as part of closed treatment.
Does percutaneous pinning fit this code?
No. Percutaneous skeletal fixation of a humeral epicondyle fracture is represented by 24566, rather than closed treatment without manipulation.
How does 24560 differ from open treatment?
24560 describes closed management without manipulation. When the fracture is treated through an open approach, the related code is 24575.
What documentation supports reporting 24560?
Document that the fracture involves a humeral epicondyle, the closed treatment provided, and that manipulation or fixation was not performed.
What care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care for this fracture treatment.
How is bilateral treatment handled?
When bilateral treatment is reported with modifier 50, Medicare pays at 150% under the CMS rule 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.
2,33224538,,Prq skel fix sprcndlr hum fx,A,,9.53,10.94,NA,10.94,,2.04,22.51,22.51,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33324545,,Optx hum fx wo ntrcndylr xtn,A,,12.82,10.27,NA,10.27,,2.67,25.76,25.76,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33424546,,Optx hum fx w/ntrcndylr xtn,A,,14.54,11.01,NA,11.01,,3.00,28.55,28.55,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33524560,,Cltx hum epcndylr fx wo mnpj,A,,2.91,8.17,,6.05,,0.62,11.70,9.58,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33624565,,Cltx hum epcndylr fx w/mnpj,A,,5.64,11.16,,7.74,,1.21,18.01,14.59,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33724566,,Prq skel fix epcndylr hum fx,A,,8.83,9.97,NA,9.97,,1.88,20.68,20.68,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,33824575,,Optx humeral epcndylr fx,A,,9.47,9.39,NA,9.39,,1.94,20.80,20.80,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537