No office rate
Both address open treatment around the elbow; 24587 is distinguished by external fixation, while 24586 includes internal fixation when performed.
On this page
CMS RVU26D · Effective 2026-10-01
24586 Elbow fracture repair Medicare reimbursement rates in Rhode Island
Open surgery treats a fracture and/or dislocation around the elbow, with internal fixation included when performed as part of the repair. Compare 24586 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 24586 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
No supported rate
Facility setting
$1000.00
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 24586: Open elbow periarticular fracture treatment
Open surgery treats a fracture and/or dislocation around the elbow, with internal fixation included when performed as part of the repair.
An orthopedic or trauma surgeon uses an open approach to treat a fracture and/or dislocation involving the area around the elbow joint. The operation may restore alignment and stabilize the injury with internal fixation. This code is suited to an operative injury pattern described as periarticular, rather than a separately defined fracture type that has its own more specific treatment code. These cases are generally performed in an operating room, often in a hospital or other surgical facility.
Report the code when the operative record supports open treatment of the periarticular injury; internal fixation performed as part of that treatment is included. Document the fracture and dislocation pattern, operative approach, reduction, and stabilization. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 24586
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.39 · 52%
- Practice expense (office) RVU11.09 · 37%
- Malpractice RVU3.14 · 11%
478
Medicare services in 2024 · #3603 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.
24586 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
Use 24579 when the operative diagnosis is a humeral condylar fracture covered by that specific code. 24586 describes periarticular elbow fracture and/or dislocation treatment.
No office rate
24685 is for open treatment of an olecranon fracture. 24586 is for periarticular fracture and/or dislocation treatment around the elbow.
$485.56
24600 describes closed treatment of an elbow dislocation; 24586 is reported for open operative treatment of a periarticular fracture and/or dislocation.
Compare 24586 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
Unavailable
Facility
$1000.00
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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 24586 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,343
- Code
- 24586
- Physician work
- 15.39
- Practice expense
- 11.09
- Malpractice
- 3.14
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.39 | × 1.019 | 15.6824 |
| Practice expense | 11.09 | × 1.033 | 11.4560 |
| Malpractice | 3.14 | × 0.892 | 2.8009 |
| Total RVUs | 29.9393 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$1000.00
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.39 | 1.019 |
| Practice expense | 11.09 | 1.033 |
| Malpractice | 3.14 | 0.892 |
(15.39 × 1.019 + 11.09 × 1.033 + 3.14 × 0.892) × $33.4009 = $1000.00
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.
24586 billing questions
When should I choose 24586 instead of 24587?
Use 24586 for open treatment when external fixation is not part of the reported service. Use 24587 when the operative treatment includes external fixation.
Is internal fixation separately reported with 24586?
Internal fixation performed as part of the open treatment is included in 24586. The record should describe the repair and stabilization performed.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. This applies to care related to the operation.
Can modifier 50 be used when both elbows are treated?
CMS lists this as a bilateral procedure: reporting with modifier 50 is paid at 150%. The operative documentation should support treatment on both sides.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; CMS does not permit team-surgery payment.
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.
2,34024577,,Cltx humrl cndylr fx w/mnpj,A,,5.86,11.39,,7.81,,1.25,18.50,14.92,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,34124579,,Optx humrl cndylr fracture,A,,11.15,9.91,NA,9.91,,2.30,23.36,23.36,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,34224582,,Prq skel fix humrl cndylr fx,A,,9.89,11.45,NA,11.45,,2.10,23.44,23.44,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,34324586,,Optx partclr fx&/dislc elbow,A,,15.39,11.09,NA,11.09,,3.14,29.62,29.62,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,34424587,,Optx partclr fx&/dslc elbw w,A,,15.40,11.25,NA,11.25,,3.27,29.92,29.92,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,34524600,,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
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