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CPT code 27786: Ankle fracture care, distal fibula, without manipulation2026 Medicare rate & RVUs in Virginia

Report this service for nonoperative treatment of a distal fibular fracture at the lateral malleolus when the provider does not manipulate the fracture.

CMS RVU26DEffective Oct 1, 2026One payment locality14.3K Medicare services in 2024

In Virginia, Medicare pays $340.76 for 27786 in the office and $285.28 when it’s performed in a hospital or facility.

$340.76Office (non-facility)
$285.28Hospital or facility
−2.7%vs the national office rate ($350.04)

Check a contract rate as a % of Medicare · 27786 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 27786 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 27786 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 27786 covers

This code covers closed, nonoperative care of a fracture at the distal fibula, or lateral malleolus, when the provider treats it without manipulating the fracture. Orthopedic surgeons and other clinicians who provide fracture care may use it for a stable lateral malleolus fracture managed with immobilization, such as a cast or brace. The fracture pattern and the treatment actually performed distinguish this service from reduction or operative repair.

Choose the code based on the documented fracture site and whether manipulation or surgery was performed. The record should identify the distal fibular fracture and support treatment without manipulation. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. If this code is performed with other procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

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.

How Virginia compares for 27786

Across 109 of 109 payment localities, the office rate for 27786 runs from $308.33 in Arkansas to $455.82 in San Benito County, CA. Virginia pays $340.76. The RVUs are the same everywhere; the geographic indexes change the dollars.

27786 in Virginia vs other payment areas
  1. Virginia · this page$340.76
  2. Los Angeles, CA · California$390.79+$50.03
  3. Washington, DC area · District of Columbia$399.00+$58.24
  4. Miami, FL · Florida$387.21+$46.45
  5. Chicago, IL · Illinois$375.26+$34.50
  6. Manhattan, NY · New York$404.77+$64.01
  7. Alaska · Alaska$406.24+$65.48

Other areas in Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

27786 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$312.99$263.60
ArkansasArkansas$308.33$259.84
ArizonaArizona$340.20$285.50
Bakersfield, CACalifornia$367.30$305.43
Chico, CACalifornia$365.79$303.92
El Centro, CACalifornia$365.88$304.01
Fresno, CACalifornia$365.79$303.92
Hanford, CACalifornia$365.79$303.92

27786 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$308.33

$410.81

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
27786 office rate range by state
State / territoryOffice rate rangeLocalities
AK$406.241
AL$312.991
AR$308.331
AZ$340.201
CA$365.79–$455.8229
CO$362.231
CT$373.801
DC$399.001
DE$345.911
FL$348.83–$387.213
GA$328.25–$357.702
GU$374.481
HI$374.481
IA$319.291
ID$321.831
IL$339.85–$375.264
IN$323.701
KS$318.651
KY$322.561
LA$322.40–$338.702
MA$360.34–$397.442
MD$352.35–$399.003
ME$324.52–$341.282
MI$332.03–$354.232
MN$344.121
MO$317.31–$338.853
MS$312.831
MT$350.011
NC$327.871
ND$339.331
NE$320.821
NH$357.371
NJ$377.23–$394.862
NM$334.261
NV$347.261
NY$332.99–$415.975
OH$329.841
OK$321.001
OR$343.75–$372.952
PA$329.88–$364.882
PR$352.341
RI$357.671
SC$329.571
SD$338.071
TN$320.411
TX$327.72–$361.748
UT$334.171
VA$340.76–$399.002
VI$352.341
VT$338.791
WA$359.40–$404.722
WI$327.741
WV$327.191
WY$345.351

See 27786 in every payment locality

How the 27786 rate is calculated

Each of 27786’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 27786

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.94

2.94 RVUs× 1.000 GPCI

Practice expense7.00

7.00 RVUs× 1.000 GPCI

Malpractice0.54

0.54 RVUs× 1.000 GPCI

Adjusted RVUs

10.4800

Conversion factor

$33.4009

Medicare rate

$350.04

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,050

Code
27786
Physician work
2.94
Practice expense
7.00
Malpractice
0.54

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 27786 in Virginia
ComponentRVULocality factorAdjusted
Physician work2.94× 1.0002.9400
Practice expense7.00× 0.9836.8810
Malpractice0.54× 0.7060.3812
Total RVUs10.2022
Conversion factor× 33.4009

Office rate, Virginia$340.76

Office: (2.94 × 1 + 7 × 0.983 + 0.54 × 0.706) × $33.4009 = $340.76

Facility: (2.94 × 1 + 5.31 × 0.983 + 0.54 × 0.706) × $33.4009 = $285.28

Open 27786 in the RVU calculator

Payment rules and modifiers for 27786

27786 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27786

Ankle fracture care, distal fibula, without manipulation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27786

Ankle fracture care, distal fibula, without manipulation

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27786 without 50 · national office

$350.04

Ankle fracture care, distal fibula, without manipulation

27786-50 · Bilateral: 150%

$525.06

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 27786

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 27786
CodeHow it relatesOffice range, Virginia
Same family
27788Ankle fracture care, distal fibula, with manipulationClosed treatment of the same distal fibular site when manipulation is performed.$483.60
27792Ankle fracture surgery, distal fibula, open treatmentOpen treatment of a distal fibular fracture at the lateral malleolus.No office rate
Used instead
27808Ankle fracture care, bimalleolar, without manipulationClosed treatment without manipulation when the ankle fracture is bimalleolar.$372.25
27810Ankle fracture treatment, bimalleolar, with manipulationClosed treatment with manipulation for a bimalleolar ankle fracture.$544.70
27814Ankle fracture, open bimalleolar treatmentOpen treatment for a bimalleolar ankle fracture.No office rate

How 27786 has changed in Virginia

27786 · Office / nonfacility

$340.76

Effective 2026-10-01

The base rate is $28.78 higher than on 2025-10-01, moving from $311.98 to $340.76 (9.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $311.98changed to$340.76

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.02 changed to 2.94
    • Practice expense RVU 6.32 changed to 7.00
    • Malpractice RVU 0.53 changed to 0.54
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $318.69changed to$311.98

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.24 changed to 6.32
    • Malpractice RVU 0.54 changed to 0.53

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $313.49changed to$318.69

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $321.43changed to$313.49

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.08 changed to 6.24
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $324.36changed to$321.43

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.88 changed to 6.08
    • Malpractice RVU 0.56 changed to 0.54
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $323.33changed to$324.36

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.80 changed to 5.88
    • Malpractice RVU 0.53 changed to 0.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $321.51changed to$323.33

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.45 changed to 5.80
    • Malpractice RVU 0.54 changed to 0.53
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $318.86changed to$321.51

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.50 changed to 0.54
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $321.00changed to$318.86

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.52 changed to 5.45

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $317.20changed to$321.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.45 changed to 5.52
    • Malpractice RVU 0.52 changed to 0.50
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $315.99changed to$317.20

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.47 changed to 5.45
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $317.84changed to$315.99

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.49 changed to 5.47

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $316.26changed to$317.84

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $313.30changed to$316.26

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.43 changed to 5.49
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $316.62changed to$313.30

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.03 changed to 5.43
    • Malpractice RVU 0.54 changed to 0.52
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $316.62

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$340.76$285.28RVU26D
2026-07-01$340.76$285.28RVU26C
2026-04-01$340.76$285.28RVU26B
2026-01-01$340.76$285.28RVU26A
2025-10-01$311.98$285.25RVU25D
2025-07-01$311.98$285.25RVU25C
2025-04-01$311.98$285.25RVU25B
2025-01-01$311.98$285.25RVU25A
2024-10-01$318.69$291.50RVU24D
2024-07-01$318.69$291.50RVU24C
2024-04-01$318.69$291.50RVU24B
2024-03-09$318.69$291.50RVU24AR
2024-01-01$313.49$286.75RVU24A
2023-10-01$321.43$294.25RVU23D
2023-07-01$321.43$294.25RVU23C
2023-04-01$321.43$294.25RVU23B
2023-01-01$321.43$294.25RVU23A
2022-10-01$324.36$297.50RVU22D
2022-07-01$324.36$297.50RVU22C
2022-04-01$324.36$297.50RVU22B
2022-01-01$324.36$297.50RVU22A
2021-10-01$323.33$295.56RVU21D
2021-07-01$323.33$295.56RVU21C
2021-04-01$323.33$295.56RVU21B
2021-01-01$323.33$295.56RVU21A
2020-10-01$321.51$294.33RVU20D
2020-07-01$321.51$294.33RVU20C
2020-04-01$321.51$294.33RVU20B
2020-01-01$321.51$294.33RVU20A
2019-10-01$318.86$290.44RVU19D
2019-07-01$318.86$290.44RVU19C
2019-04-01$318.86$290.44RVU19B
2019-01-01$318.86$290.44RVU19A
2018-10-01$321.00$289.76RVU18D
2018-07-01$321.00$289.76RVU18C
2018-04-01$321.00$289.76RVU18B
2018-01-01$321.00$289.76RVU18AR1
2017-10-01$317.20$287.51RVU17D
2017-07-01$317.20$287.51RVU17C
2017-04-01$317.20$287.51RVU17B
2017-01-01$317.20$287.51RVU17A
2016-10-01$315.99$286.07RVU16D
2016-07-01$315.99$286.07RVU16C
2016-04-01$315.99$286.07RVU16B
2016-01-01$315.99$286.07RVU16A
2015-10-01$317.84$287.11RVU15D
2015-07-01$317.84$287.11RVU15C
2015-04-01$316.26$285.68RVU15B
2015-01-01$316.26$285.68RVU15A
2014-10-01$313.30$283.82RVU14D
2014-07-01$313.30$283.82RVU14C
2014-04-01$313.30$283.82RVU14B
2014-01-01$313.30$283.82RVU14A
2013-10-01$316.62$285.37RVU13D
2013-07-01$316.62$285.37RVU13C
2013-04-01$316.62$285.37RVU13B
2013-01-01$316.62$285.37RVU13AR

Price 27786 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

27786 billing questions

How is this code different from 27788?

Both describe closed treatment of a distal fibular fracture at the lateral malleolus. Use 27786 when the provider does not manipulate the fracture; 27788 describes treatment with manipulation.

When is 27792 more appropriate?

Use 27792 when the distal fibular fracture is treated operatively through an open approach. This code describes closed treatment without manipulation.

Can modifier 50 be reported for bilateral fractures?

Yes. CMS lists this as a bilateral procedure; modifier 50 is paid at 150% when the service is performed bilaterally.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

What documentation supports choosing this code?

Document the distal fibular or lateral malleolar fracture and that it was treated closed without manipulation. If the treatment involves manipulation or open repair, choose the corresponding code instead.

Can an assistant or co-surgeon be paid for this service?

CMS lists a statutory restriction on assistant-at-surgery payment. Co-surgeons and team surgery are not permitted 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 27786PPRRVU2026_Oct_nonQPP.csv, line 3,050 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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