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CPT code 27808: Ankle fracture care, bimalleolar, without manipulation2026 Medicare rate & RVUs in Houston, TX

Report closed treatment of a bimalleolar ankle fracture when the fracture is managed without manipulation, such as with immobilization in a cast or boot.

CMS RVU26DEffective Oct 1, 2026One payment locality2.2K Medicare services in 2024

In Houston, TX, Medicare pays $388.66 for 27808 in the office and $326.64 when it’s performed in a hospital or facility.

$388.66Office (non-facility)
$326.64Hospital or facility
+1.6%vs the national office rate ($382.44)

Check a contract rate as a % of Medicare · 27808 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 27808 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 27808 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 27808 covers

This code covers closed care of a bimalleolar ankle fracture without manipulation, such as a fracture involving the medial and lateral malleoli or the lateral and posterior malleoli. An orthopedic surgeon or another clinician who provides fracture care may diagnose the injury and choose immobilization, commonly with a cast or boot. The fracture is managed without manually manipulating it to obtain a reduction.

Select the code from the documented fracture pattern and treatment: two malleoli are involved, and the provider does not manipulate the fracture. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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 Houston, TX compares for 27808

Across 109 of 109 payment localities, the office rate for 27808 runs from $335.75 in Arkansas to $501.21 in San Benito County, CA. Houston, TX pays $388.66. The RVUs are the same everywhere; the geographic indexes change the dollars.

27808 in Houston, TX vs other payment areas
  1. Houston, TX · this page$388.66
  2. Austin, TX · Texas$395.77+$7.11
  3. Beaumont, TX · Texas$357.26−$31.40
  4. Brazoria, TX · Texas$376.59−$12.07
  5. Dallas, TX · Texas$379.52−$9.14
  6. Fort Worth, TX · Texas$377.12−$11.54
  7. Galveston, TX · Texas$378.04−$10.62

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

Every other payment area

27808 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$367.07$307.80
Los Angeles, CACalifornia$428.38$354.49
Washington, DC areaDistrict of Columbia$437.04$363.46
Miami, FLFlorida$422.91$357.89
Chicago, ILIllinois$409.54$346.77
Manhattan, NYNew York$442.95$370.38
AlaskaAlaska$440.20$373.68
AlabamaAlabama$340.97$286.31

27808 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.

$335.75

$450.87

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

View every state and territory as a table
27808 office rate range by state
State / territoryOffice rate rangeLocalities
AK$440.201
AL$340.971
AR$335.751
AZ$371.451
CA$400.52–$501.2129
CO$396.311
CT$408.851
DC$437.041
DE$377.801
FL$380.55–$422.913
GA$357.59–$390.862
GU$410.531
HI$410.531
IA$348.271
ID$351.071
IL$370.33–$409.544
IN$353.171
KS$347.441
KY$351.431
LA$351.21–$369.472
MA$394.10–$435.672
MD$385.01–$437.043
ME$353.95–$372.912
MI$361.92–$386.472
MN$376.471
MO$345.43–$369.783
MS$340.611
MT$382.401
NC$357.721
ND$370.931
NE$350.021
NH$390.861
NJ$412.60–$432.292
NM$364.381
NV$379.471
NY$363.46–$455.355
OH$359.581
OK$349.811
OR$375.63–$408.422
PA$359.68–$398.802
PR$385.061
RI$390.951
SC$359.431
SD$369.581
TN$349.401
TX$357.26–$395.778
UT$364.591
VA$372.25–$437.042
VI$385.061
VT$370.221
WA$393.11–$443.872
WI$357.921
WV$356.141
WY$377.401

See 27808 in every payment locality

How the 27808 rate is calculated

Each of 27808’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 · 27808

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.95

2.95 RVUs× 1.000 GPCI

Practice expense7.92

7.92 RVUs× 1.000 GPCI

Malpractice0.58

0.58 RVUs× 1.000 GPCI

Adjusted RVUs

11.4500

Conversion factor

$33.4009

Medicare rate

$382.44

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

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,053

Code
27808
Physician work
2.95
Practice expense
7.92
Malpractice
0.58

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 27808 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work2.95× 1.0082.9736
Practice expense7.92× 0.9937.8646
Malpractice0.58× 1.3760.7981
Total RVUs11.6362
Conversion factor× 33.4009

Office rate, Houston, TX$388.66

Office: (2.95 × 1.008 + 7.92 × 0.993 + 0.58 × 1.376) × $33.4009 = $388.66

Facility: (2.95 × 1.008 + 6.05 × 0.993 + 0.58 × 1.376) × $33.4009 = $326.64

Open 27808 in the RVU calculator

Payment rules and modifiers for 27808

27808 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27808

Ankle fracture care, bimalleolar, 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 · 27808

Ankle fracture care, bimalleolar, 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

27808 without 50 · national office

$382.44

Ankle fracture care, bimalleolar, without manipulation

27808-50 · Bilateral: 150%

$573.66

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 27808

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

Codes related to 27808
CodeHow it relatesOffice range, Houston, TX
Same family
27810Ankle fracture treatment, bimalleolar, with manipulationClosed treatment of a bimalleolar fracture when manipulation is performed.$575.77
27816Ankle fracture care, trimalleolar, no manipulationClosed treatment without manipulation for a trimalleolar fracture.$388.86
27818Ankle fracture care, trimalleolar, with manipulationClosed treatment with manipulation for a trimalleolar fracture.$599.53
Used instead
27814Ankle fracture, open bimalleolar treatmentOpen treatment for a bimalleolar fracture rather than closed care.No office rate

How 27808 has changed in Houston, TX

27808 · Office / nonfacility

$388.66

Effective 2026-10-01

The base rate is $35.09 higher than on 2025-10-01, moving from $353.57 to $388.66 (9.9%).

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

    $353.57changed to$388.66

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.03 changed to 2.95
    • Practice expense RVU 7.02 changed to 7.92
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $360.05changed to$353.57

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.92 changed to 7.02
    • Malpractice RVU 0.57 changed to 0.58

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $354.17changed to$360.05

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $358.30changed to$354.17

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.72 changed to 6.92
    • Malpractice RVU 0.56 changed to 0.57
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $357.43changed to$358.30

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.50 changed to 6.72
    • Malpractice RVU 0.57 changed to 0.56
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $356.13changed to$357.43

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.39 changed to 6.50
    • Malpractice RVU 0.56 changed to 0.57

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $350.88changed to$356.13

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.98 changed to 6.39
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $347.00changed to$350.88

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.97 changed to 5.98
    • Malpractice RVU 0.53 changed to 0.56
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $348.44changed to$347.00

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.02 changed to 5.97

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $344.35changed to$348.44

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.94 changed to 6.02
    • Malpractice RVU 0.54 changed to 0.53
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $343.33changed to$344.35

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.95 changed to 5.94
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $344.93changed to$343.33

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.96 changed to 5.95

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $343.21changed to$344.93

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $340.79changed to$343.21

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.91 changed to 5.96
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $344.90changed to$340.79

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.55 changed to 5.91
    • Malpractice RVU 0.56 changed to 0.54
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $344.90

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$388.66$326.64RVU26D
2026-07-01$388.66$326.64RVU26C
2026-04-01$388.66$326.64RVU26B
2026-01-01$388.66$326.64RVU26A
2025-10-01$353.57$322.42RVU25D
2025-07-01$353.57$322.42RVU25C
2025-04-01$353.57$322.42RVU25B
2025-01-01$353.57$322.42RVU25A
2024-10-01$360.05$328.33RVU24D
2024-07-01$360.05$328.33RVU24C
2024-04-01$360.05$328.33RVU24B
2024-03-09$360.05$328.33RVU24AR
2024-01-01$354.17$322.97RVU24A
2023-10-01$358.30$326.97RVU23D
2023-07-01$358.30$326.97RVU23C
2023-04-01$358.30$326.97RVU23B
2023-01-01$358.30$326.97RVU23A
2022-10-01$357.43$325.74RVU22D
2022-07-01$357.43$325.74RVU22C
2022-04-01$357.43$325.74RVU22B
2022-01-01$357.43$325.74RVU22A
2021-10-01$356.13$323.45RVU21D
2021-07-01$356.13$323.45RVU21C
2021-04-01$356.13$323.45RVU21B
2021-01-01$356.13$323.45RVU21A
2020-10-01$350.88$318.85RVU20D
2020-07-01$350.88$318.85RVU20C
2020-04-01$350.88$318.85RVU20B
2020-01-01$350.88$318.85RVU20A
2019-10-01$347.00$313.81RVU19D
2019-07-01$347.00$313.81RVU19C
2019-04-01$347.00$313.81RVU19B
2019-01-01$347.00$313.81RVU19A
2018-10-01$348.44$311.64RVU18D
2018-07-01$348.44$311.64RVU18C
2018-04-01$348.44$311.64RVU18B
2018-01-01$348.44$311.64RVU18AR1
2017-10-01$344.35$309.59RVU17D
2017-07-01$344.35$309.59RVU17C
2017-04-01$344.35$309.59RVU17B
2017-01-01$344.35$309.59RVU17A
2016-10-01$343.33$308.75RVU16D
2016-07-01$343.33$308.75RVU16C
2016-04-01$343.33$308.75RVU16B
2016-01-01$343.33$308.75RVU16A
2015-10-01$344.93$310.22RVU15D
2015-07-01$344.93$310.22RVU15C
2015-04-01$343.21$308.68RVU15B
2015-01-01$343.21$308.68RVU15A
2014-10-01$340.79$306.98RVU14D
2014-07-01$340.79$306.98RVU14C
2014-04-01$340.79$306.98RVU14B
2014-01-01$340.79$306.98RVU14A
2013-10-01$344.90$309.10RVU13D
2013-07-01$344.90$309.10RVU13C
2013-04-01$344.90$309.10RVU13B
2013-01-01$344.90$309.10RVU13AR

Price 27808 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

27808 billing questions

When is 27808 appropriate instead of 27810?

Use 27808 for a bimalleolar fracture treated without manipulation. Use 27810 when the provider manipulates the fracture.

How does 27808 differ from 27814?

27808 describes closed treatment without manipulation. 27814 is for open treatment of a bimalleolar fracture.

Can cast application be billed separately?

The immobilization used as part of the fracture treatment is included in the fracture-care service. Do not separately report a cast application for that same treatment.

What documentation supports 27808?

Document the malleoli involved and the closed treatment provided. The record should support that the provider treated the fracture without manipulation.

How does the global period affect follow-up visits?

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

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery 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 27808PPRRVU2026_Oct_nonQPP.csv, line 3,053 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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