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CPT code 27788: Ankle fracture care, distal fibula, with manipulation2026 Medicare rate & RVUs in Kentucky

Report closed treatment with manipulation for a distal fibular fracture at the lateral malleolus when the clinician performs a closed reduction.

CMS RVU26DEffective Oct 1, 2026One payment locality1K Medicare services in 2024

In Kentucky, Medicare pays $460.94 for 27788 in the office and $385.82 when it’s performed in a hospital or facility.

$460.94Office (non-facility)
$385.82Hospital or facility
−7.6%vs the national office rate ($498.68)

Check a contract rate as a % of Medicare · 27788 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 27788 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kentucky
  2. What 27788 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 27788 covers

This code represents closed treatment of a distal fibular fracture at the lateral malleolus when the clinician manipulates the fracture to improve alignment. It is typically reported by an orthopedic surgeon or other qualified treating clinician after a closed reduction, with immobilization such as a cast or splint. The fracture may be managed in an office, emergency department, or hospital setting; the code hinges on the manipulation, not the location of care.

Choose this code when documentation supports a distal fibular fracture and closed manipulation, rather than closed treatment without manipulation or open treatment. The record should identify the fracture site, reduction or manipulation performed, and treatment plan. 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily 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 Kentucky compares for 27788

Across 109 of 109 payment localities, the office rate for 27788 runs from $438.27 in Arkansas to $639.01 in San Benito County, CA. Kentucky pays $460.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

27788 in Kentucky vs other payment areas
  1. Kentucky · this page$460.94
  2. Los Angeles, CA · California$551.33+$90.39
  3. Washington, DC area · District of Columbia$566.57+$105.63
  4. Miami, FL · Florida$562.13+$101.19
  5. Chicago, IL · Illinois$544.13+$83.19
  6. Manhattan, NY · New York$578.69+$117.75
  7. Alaska · Alaska$579.77+$118.83

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

Every other payment area

27788 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$444.99$371.05
ArkansasArkansas$438.27$365.69
ArizonaArizona$484.16$402.28
Bakersfield, CACalifornia$518.82$426.20
Chico, CACalifornia$516.10$423.49
El Centro, CACalifornia$516.27$423.65
Fresno, CACalifornia$516.10$423.49
Hanford, CACalifornia$516.10$423.49

27788 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.

$438.27

$579.77

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

View every state and territory as a table
27788 office rate range by state
State / territoryOffice rate rangeLocalities
AK$579.771
AL$444.991
AR$438.271
AZ$484.161
CA$516.10–$639.0129
CO$513.381
CT$532.871
DC$566.571
DE$492.311
FL$501.46–$562.133
GA$471.04–$510.812
GU$527.861
HI$527.861
IA$451.991
ID$456.081
IL$489.92–$544.134
IN$458.711
KS$452.071
KY$460.941
LA$461.10–$484.612
MA$511.05–$562.272
MD$501.25–$566.573
ME$461.01–$483.642
MI$475.57–$510.352
MN$484.521
MO$454.40–$483.643
MS$446.311
MT$498.611
NC$465.661
ND$479.031
NE$453.881
NH$507.441
NJ$536.87–$560.782
NM$479.211
NV$493.471
NY$473.12–$596.145
OH$471.571
OK$457.641
OR$487.60–$527.552
PA$471.06–$520.672
PR$501.641
RI$508.361
SC$469.801
SD$476.721
TN$454.731
TX$468.01–$513.468
UT$476.421
VA$483.60–$566.572
VI$501.641
VT$479.191
WA$509.41–$571.602
WI$462.581
WV$471.711
WY$490.081

See 27788 in every payment locality

How the 27788 rate is calculated

Each of 27788’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 · 27788

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.52

4.52 RVUs× 1.000 GPCI

Practice expense9.42

9.42 RVUs× 1.000 GPCI

Malpractice0.99

0.99 RVUs× 1.000 GPCI

Adjusted RVUs

14.9300

Conversion factor

$33.4009

Medicare rate

$498.68

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

The exact Kentucky inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,051

Code
27788
Physician work
4.52
Practice expense
9.42
Malpractice
0.99

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for 27788 in Kentucky
ComponentRVULocality factorAdjusted
Physician work4.52× 1.0004.5200
Practice expense9.42× 0.8898.3744
Malpractice0.99× 0.9150.9059
Total RVUs13.8002
Conversion factor× 33.4009

Office rate, Kentucky$460.94

Office: (4.52 × 1 + 9.42 × 0.889 + 0.99 × 0.915) × $33.4009 = $460.94

Facility: (4.52 × 1 + 6.89 × 0.889 + 0.99 × 0.915) × $33.4009 = $385.82

Open 27788 in the RVU calculator

Payment rules and modifiers for 27788

27788 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27788

Ankle fracture care, distal fibula, with 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 · 27788

Ankle fracture care, distal fibula, with 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

27788 without 50 · national office

$498.68

Ankle fracture care, distal fibula, with manipulation

27788-50 · Bilateral: 150%

$748.02

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 27788

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

Codes related to 27788
CodeHow it relatesOffice range, Kentucky
Same family
27786Ankle fracture care, distal fibula, without manipulationClosed treatment of a distal fibular fracture without manipulation.$322.56
27762Ankle fracture care, medial malleolus, with manipulationClosed treatment with manipulation for a medial malleolar fracture.$544.60
27768Ankle fracture treatment, posterior malleolus, with manipulationClosed treatment with manipulation for a posterior malleolar fracture.No office rate
Used instead
27792Ankle fracture surgery, distal fibula, open treatmentOpen treatment for a distal fibular fracture instead of closed treatment.No office rate

How 27788 has changed in Kentucky

27788 · Office / nonfacility

$460.94

Effective 2026-10-01

The base rate is $63.30 higher than on 2025-10-01, moving from $397.64 to $460.94 (15.9%).

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

    $397.64changed to$460.94

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.64 changed to 4.52
    • Practice expense RVU 7.80 changed to 9.42
    • Malpractice RVU 0.89 changed to 0.99
    • Practice expense GPCI 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $406.31changed to$397.64

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.68 changed to 7.80
    • Malpractice RVU 0.91 changed to 0.89

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $399.68changed to$406.31

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $405.94changed to$399.68

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.52 changed to 7.68
    • Malpractice RVU 0.89 changed to 0.91
    • Practice expense GPCI 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913

  5. January 1, 2023

    RVU23A

    $403.76changed to$405.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.23 changed to 7.52
    • Malpractice RVU 0.90 changed to 0.89
    • Practice expense GPCI 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $402.61changed to$403.76

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.12 changed to 7.23
    • Malpractice RVU 0.86 changed to 0.90

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $404.63changed to$402.61

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.70 changed to 7.12
    • Malpractice RVU 0.87 changed to 0.86
    • Practice expense GPCI 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $402.05changed to$404.63

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.66 changed to 6.70
    • Malpractice RVU 0.80 changed to 0.87
    • Practice expense GPCI 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $400.34changed to$402.05

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.62 changed to 6.66

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $395.59changed to$400.34

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.54 changed to 6.62
    • Malpractice RVU 0.81 changed to 0.80
    • Practice expense GPCI 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $393.97changed to$395.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.55 changed to 6.54
    • Malpractice RVU 0.82 changed to 0.81
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $395.97changed to$393.97

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.84 changed to 0.82

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $394.00changed to$395.97

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $391.44changed to$394.00

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.50 changed to 6.55
    • Malpractice RVU 0.80 changed to 0.84
    • Malpractice GPCI 0.774 changed to 0.795

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $393.61changed to$391.44

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.23 changed to 6.50
    • Malpractice RVU 0.84 changed to 0.80
    • Practice expense GPCI 0.871 changed to 0.872
    • Malpractice GPCI 0.752 changed to 0.774

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $393.61

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$460.94$385.82RVU26D
2026-07-01$460.94$385.82RVU26C
2026-04-01$460.94$385.82RVU26B
2026-01-01$460.94$385.82RVU26A
2025-10-01$397.64$361.05RVU25D
2025-07-01$397.64$361.05RVU25C
2025-04-01$397.64$361.05RVU25B
2025-01-01$397.64$361.05RVU25A
2024-10-01$406.31$368.95RVU24D
2024-07-01$406.31$368.95RVU24C
2024-04-01$406.31$368.95RVU24B
2024-03-09$406.31$368.95RVU24AR
2024-01-01$399.68$362.92RVU24A
2023-10-01$405.94$368.67RVU23D
2023-07-01$405.94$368.67RVU23C
2023-04-01$405.94$368.67RVU23B
2023-01-01$405.94$368.67RVU23A
2022-10-01$403.76$367.37RVU22D
2022-07-01$403.76$367.37RVU22C
2022-04-01$403.76$367.37RVU22B
2022-01-01$403.76$367.37RVU22A
2021-10-01$402.61$366.23RVU21D
2021-07-01$402.61$366.23RVU21C
2021-04-01$402.61$366.23RVU21B
2021-01-01$402.61$366.23RVU21A
2020-10-01$404.63$369.62RVU20D
2020-07-01$404.63$369.62RVU20C
2020-04-01$404.63$369.62RVU20B
2020-01-01$404.63$369.62RVU20A
2019-10-01$402.05$367.48RVU19D
2019-07-01$402.05$367.48RVU19C
2019-04-01$402.05$367.48RVU19B
2019-01-01$402.05$367.48RVU19A
2018-10-01$400.34$366.13RVU18D
2018-07-01$400.34$366.13RVU18C
2018-04-01$400.34$366.13RVU18B
2018-01-01$400.34$366.13RVU18AR1
2017-10-01$395.59$363.21RVU17D
2017-07-01$395.59$363.21RVU17C
2017-04-01$395.59$363.21RVU17B
2017-01-01$395.59$363.21RVU17A
2016-10-01$393.97$362.13RVU16D
2016-07-01$393.97$362.13RVU16C
2016-04-01$393.97$362.13RVU16B
2016-01-01$393.97$362.13RVU16A
2015-10-01$395.97$363.69RVU15D
2015-07-01$395.97$363.69RVU15C
2015-04-01$394.00$361.88RVU15B
2015-01-01$394.00$361.88RVU15A
2014-10-01$391.44$359.89RVU14D
2014-07-01$391.44$359.89RVU14C
2014-04-01$391.44$359.89RVU14B
2014-01-01$391.44$359.89RVU14A
2013-10-01$393.61$360.13RVU13D
2013-07-01$393.61$360.13RVU13C
2013-04-01$393.61$360.13RVU13B
2013-01-01$393.61$360.13RVU13AR

Price 27788 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

27788 billing questions

How does this code differ from 27786?

Both concern closed treatment of a distal fibular fracture at the lateral malleolus. Use 27788 when manipulation is performed; 27786 describes treatment without manipulation.

When is 27792 a better fit?

Use 27792 for open treatment of a distal fibular fracture. This code is for closed treatment with manipulation.

Is fracture follow-up included?

CMS assigns this code a 90-day global period. Related postoperative care during that period is included, as is the day-before preoperative visit.

How is bilateral treatment reported?

CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document the treatment performed on both sides.

Can an assistant or co-surgeon be billed?

CMS applies a statutory restriction to assistant-at-surgery payment for this code. Co-surgeons and team surgery are 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 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 27788PPRRVU2026_Oct_nonQPP.csv, line 3,051 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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