$365.00
Use 24560 for closed treatment of a humeral epicondyle fracture without manipulation; use this code when the fracture is treated through an open surgical approach.
On this page
CMS RVU26D · Effective 2026-10-01
24575 Epicondylar fracture repair Medicare reimbursement rates in Wisconsin
Reports open surgical treatment of a humeral epicondyle fracture, including reduction and internal fixation when performed, rather than closed or percutaneous treatment. Compare 24575 office and facility rates across CMS payment localities in Wisconsin.
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 24575 in Wisconsin?
Wisconsin 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
$636.73
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 24575: Open treatment of humeral epicondyle fracture
Reports open surgical treatment of a humeral epicondyle fracture, including reduction and internal fixation when performed, rather than closed or percutaneous treatment.
An orthopedic surgeon exposes a fracture of the medial or lateral epicondyle of the humerus and restores the fracture alignment. Internal fixation may be used as part of the open treatment. This service is typically performed in an operating room for a fracture requiring surgical exposure and treatment; it is distinct from manipulation through the skin or percutaneous skeletal fixation.
Report the code for open treatment of the epicondylar fracture, not for a humeral shaft or condylar fracture. The operative report should identify the fracture site and document the open treatment and any fixation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one 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 payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 24575
- 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 RVU9.47 · 46%
- Practice expense (office) RVU9.39 · 45%
- Malpractice RVU1.94 · 9%
144
Medicare services in 2024 · #4591 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.
24575 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$557.93
24565 is closed treatment with manipulation. This code describes open treatment, not closed reduction.
No office rate
24566 is for percutaneous skeletal fixation of a humeral epicondyle fracture. This code is for open treatment.
No office rate
24579 describes open treatment of a humeral condylar fracture. Distinguish the condyle from the epicondyle in the operative diagnosis and report.
Compare 24575 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$636.73
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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 24575 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
2,338
- Code
- 24575
- Physician work
- 9.47
- Practice expense
- 9.39
- Malpractice
- 1.94
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.47 | × 1.000 | 9.4700 |
| Practice expense | 9.39 | × 0.958 | 8.9956 |
| Malpractice | 1.94 | × 0.308 | 0.5975 |
| Total RVUs | 19.0631 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$636.73
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.47 | 1 |
| Practice expense | 9.39 | 0.958 |
| Malpractice | 1.94 | 0.308 |
(9.47 × 1 + 9.39 × 0.958 + 1.94 × 0.308) × $33.4009 = $636.73
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.
24575 billing questions
How is this different from closed treatment of a humeral epicondyle fracture?
This code is for open surgical treatment. Closed treatment without manipulation or with manipulation is reported with 24560 or 24565, respectively.
When would 24566 be used instead?
24566 describes percutaneous skeletal fixation of a humeral epicondyle fracture. Use this code when treatment is open rather than performed through percutaneous fixation.
Does the code include internal fixation?
Internal fixation may be performed as part of the open treatment. The operative report should document the treatment and fixation actually performed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard 50% multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is 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.
2,33524560,,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
2,33924576,,Cltx humrl cndylr fx wo mnpj,A,,2.98,8.65,,6.49,,0.64,12.27,10.11,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,34024577,,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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,