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See a sample rate comparisonCPT 24586 Fee Schedule
Medicare rates as of October 2026
CPT 24586 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Surgery On Broken Elbow, Surgery To Repair A Break At The Elbow Of The Upper Arm (Humerus) Or One Or Both Of The Lower Arm Bones (Radius Ulna). This Type Of Break Usually Involves Dislocation Of The Elbow Joint. Pins Screws Or Wires May Hold The Bones In Place.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 21Inpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5115 - Level 5 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 03600960Sign up to view all 4 |
| Medicare Fee Schedule | $989.34 national non-facility rate (2026)View Medicare rates for 24586 |
| Medicaid Fee Schedule | $787.875 median of the 8 states in the free previewView Medicaid rates for 24586 |
National average reimbursement for CPT 24586 by major payers:
$1,438.34
BCBS / Anthem
$1,472.52
UnitedHealthcare
$1,536.66
Aetna
$1,778.31
Cigna
Compare published rates across providers.
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CPT 24586
5 of 25 sample ratesHigher to lower in this preview
Memorial Care Surgical Center At Orange Coast, LLC
Memorial Care Surgical Center At Orange Coast LLC
$14,316.00Published rateThe Surgery Center, LLC
The Surgery Center LLC
$5,694.00Published rateVertrae Surgery Center, LLC
$3,246.00Published rateSpring Creek Surgery Center LLC
$1,967.00Published rateKleinert Kutz Surgery Center, LLC
Kleinert Kutz Surgery Center LLC
$855.96Published rate
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See a sample payer proposalCPT 24586 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 24586. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 24579-CPT | Surgical Repair Of Broken Arm, Surgery To Repair A Broken Upper Arm Bone (Humerus). The Procedure Can Involve The Use Of Wires Pins Plates Rings Or Screws To Hold The Bone Together. Repair May Include A Prosthesis Or Implant. |
| 24582-CPT | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Humeral Condylarfracturemedial Or Lateral With Manipulation Pe Rcutaneous Skeletal Fixation Of Humeral Condylar Fracture |
| 24586-CPT | Surgery On Broken Elbow, Surgery To Repair A Break At The Elbow Of The Upper Arm (Humerus) Or One Or Both Of The Lower Arm Bones (Radius Ulna). This Type Of Break Usually Involves Dislocation Of The Elbow Joint. Pins Screws Or Wires May Hold The Bones In Place. |
| 24587-CPT | Optx Partclr Fx&/Dslc Elbw W, Open Treatment Of Periarticular Fracture And/Or Dislocation Of The Elbow (Fracture Distal Humerus And Proximal Ulna And/Or Proximal Radius); With Implant Arthroplasty |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 24586. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 24586 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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Frequently Asked Questions
What APC is CPT 24586 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 24586 to APC 5115 (Level 5 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 24586 in an ambulatory surgery center?
CMS lists CPT 24586 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 24586?
Hospital price transparency files list CPT 24586 under these revenue codes: 0360, 0960, 0450 and 0361. A revenue code names the hospital department or charge category for the line; it does not change what the service is.