CPT 24535 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 23 - Emergency Room • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 24535 |
National average reimbursement for CPT 24535 by major payers:
$817.87
$822.48
$862.25
$1,040.78
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 24535 | ||||||
United | 24535 | $574.00 | 1548217128 - GULFSHORE ENDOSCOPY CENTER LLC | 650615196 - (FL) GULFSHORE ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $566.00 | 1396342481 - PIEDMONT ASC LLC | 851448653 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $105.00 | 1679602544 - TGH SURGERY CENTER AT MORSANI, LLC, TGH SURGERY CENTER | 812203868 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $159.00 | 1710952841 - ANDOCHICK SURGICAL CENTER LLC, PHYSICIANS SURGERY CENTER OF FREDERICK | 522239166 - (MD) ANDOCHICK SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $117.00 | 1215302906 - RADIUS SURGERY CENTER LLC | 474627643 - (GA) RADIUS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $88.00 | 1487608071 - SAN BERNARDINO EYE SURGERY CENTER, LLC, THE EYE SURGERY CENTER | 330991348 - SAN BERNARDINO EYE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $250.00 | 1669720397 - PLEASANT VIEW SURGERY CENTER, LLC | 455254219 - (ID) PLEASANT VIEW SURGERY CENTER, LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $78.00 | 1154449643 - AUGUSTA EYE SURGERY, LLC | 205644814 - (GA) AUGUSTA EYE SURGERY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $124.00 | 1275564346 - CEDAR OAKS SURGERY CENTER LLC | 450528697 - (MO) CEDAR OAKS SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $87.00 | 1386892230 - NORMAN ENDOSCOPY CENTER, LLC | 208716173 - (OK) NORMAN ENDOSCOPY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $104.00 | 1154412757 - SURGICENTER LTD, BLOOMBERG EYE CENTER | 311585329 - (OH) SURGICENTER LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $555.00 | 1275292229 - SCOTTSDALE ENDOSCOPY ASC LLC | 873952617 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $125.00 | 1275142804 - ATLAS SURGERY CENTER, LLC, ATLAS SURGERY CENTER, LLC | 842922573 - (MN) ATLAS SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $175.00 | 1275595746 - REGIONAL SURGICAL CENTRE, INC. | 640911313 - (MS) REGIONAL SURGICAL CENTRE INC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 24535 | $142.00 | 1154412120 - SURGICORE, INC. | 363567890 - (IL) SURGICORE INC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 24535 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 24535 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 24535 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 24530-CPT | Moderate | Closed Treatment Of Supracondylar Or Transcondylar Humeral Fracture, With Or Without Intercondylar Extension; Without Manipulation |
| 24535-CPT | Moderate | Closed Treatment Of Supracondylar Or Transcondylar Humeral Fracture, With Or Without Intercondylar Extension; With Manipulation, With Or Without Skin Or Skeletal Traction |
| 24538-CPT | High | Percutaneous Skeletal Fixation Of Supracondylar Or Transcondylar Humeral Fracture, With Or Without Intercondylar Extension |
| 24545-CPT | High | Open Treatment Of Humeral Supracondylar Or Transcondylar Fracture, Includes Internal Fixation, When Performed; Without Intercondylar Extension |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 24535. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 24535 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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