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CPT code 27808: Ankle fracture care, bimalleolar, without manipulation2026 Medicare rate & RVUs in King County, WA

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 King County, WA, Medicare pays $443.87 for 27808 in the office and $367.23 when it’s performed in a hospital or facility.

$443.87Office (non-facility)
$367.23Hospital or facility
+16.1%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 King County, WA
  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 King County, WA 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. King County, WA pays $443.87. The RVUs are the same everywhere; the geographic indexes change the dollars.

27808 in King County, WA vs other payment areas
  1. King County, WA · this page$443.87
  2. Rest of Washington · Washington$393.11−$50.76
  3. Los Angeles, CA · California$428.38−$15.49
  4. Washington, DC area · District of Columbia$437.04−$6.83
  5. Miami, FL · Florida$422.91−$20.96
  6. Chicago, IL · Illinois$409.54−$34.33
  7. Manhattan, NY · New York$442.95−$0.92

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

Every other payment area

27808 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$440.20$373.68
AlabamaAlabama$340.97$286.31
ArkansasArkansas$335.75$282.09
ArizonaArizona$371.45$310.93
Bakersfield, CACalifornia$402.13$333.68
Chico, CACalifornia$400.52$332.07
El Centro, CACalifornia$400.62$332.16
Fresno, CACalifornia$400.52$332.07

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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 27808 in King County, WA
ComponentRVULocality factorAdjusted
Physician work2.95× 1.0503.0975
Practice expense7.92× 1.2279.7178
Malpractice0.58× 0.8170.4739
Total RVUs13.2892
Conversion factor× 33.4009

Office rate, King County, WA$443.87

Office: (2.95 × 1.05 + 7.92 × 1.227 + 0.58 × 0.817) × $33.4009 = $443.87

Facility: (2.95 × 1.05 + 6.05 × 1.227 + 0.58 × 0.817) × $33.4009 = $367.23

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, King County, WA
Same family
27810Ankle fracture treatment, bimalleolar, with manipulationClosed treatment of a bimalleolar fracture when manipulation is performed.$643.04
27816Ankle fracture care, trimalleolar, no manipulationClosed treatment without manipulation for a trimalleolar fracture.$442.68
27818Ankle fracture care, trimalleolar, with manipulationClosed treatment with manipulation for a trimalleolar fracture.$667.68
Used instead
27814Ankle fracture, open bimalleolar treatmentOpen treatment for a bimalleolar fracture rather than closed care.No office rate

How 27808 has changed in King County, WA

27808 · Office / nonfacility

$443.87

Effective 2026-10-01

The base rate is $48.61 higher than on 2025-10-01, moving from $395.26 to $443.87 (12.3%).

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

    $395.26changed to$443.87

    • 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 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $402.41changed to$395.26

    • 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

    $395.84changed to$402.41

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $397.01changed to$395.84

    • 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 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $392.52changed to$397.01

    • 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 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $390.92changed to$392.52

    • 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

    $382.51changed to$390.92

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.98 changed to 6.39
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $376.50changed to$382.51

    • 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 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $378.15changed to$376.50

    • 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

    $370.76changed to$378.15

    • 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
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $366.83changed to$370.76

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.95 changed to 5.94
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $368.56changed to$366.83

    • 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

    $366.73changed to$368.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $368.04changed to$366.73

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.91 changed to 5.96
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $377.39changed to$368.04

    • 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
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $377.39

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$443.87$367.23RVU26D
2026-07-01$443.87$367.23RVU26C
2026-04-01$443.87$367.23RVU26B
2026-01-01$443.87$367.23RVU26A
2025-10-01$395.26$357.37RVU25D
2025-07-01$395.26$357.37RVU25C
2025-04-01$395.26$357.37RVU25B
2025-01-01$395.26$357.37RVU25A
2024-10-01$402.41$363.83RVU24D
2024-07-01$402.41$363.83RVU24C
2024-04-01$402.41$363.83RVU24B
2024-03-09$402.41$363.83RVU24AR
2024-01-01$395.84$357.89RVU24A
2023-10-01$397.01$359.79RVU23D
2023-07-01$397.01$359.79RVU23C
2023-04-01$397.01$359.79RVU23B
2023-01-01$397.01$359.79RVU23A
2022-10-01$392.52$355.74RVU22D
2022-07-01$392.52$355.74RVU22C
2022-04-01$392.52$355.74RVU22B
2022-01-01$392.52$355.74RVU22A
2021-10-01$390.92$353.01RVU21D
2021-07-01$390.92$353.01RVU21C
2021-04-01$390.92$353.01RVU21B
2021-01-01$390.92$353.01RVU21A
2020-10-01$382.51$345.77RVU20D
2020-07-01$382.51$345.77RVU20C
2020-04-01$382.51$345.77RVU20B
2020-01-01$382.51$345.77RVU20A
2019-10-01$376.50$338.91RVU19D
2019-07-01$376.50$338.91RVU19C
2019-04-01$376.50$338.91RVU19B
2019-01-01$376.50$338.91RVU19A
2018-10-01$378.15$336.48RVU18D
2018-07-01$378.15$336.48RVU18C
2018-04-01$378.15$336.48RVU18B
2018-01-01$378.15$336.48RVU18AR1
2017-10-01$370.76$331.10RVU17D
2017-07-01$370.76$331.10RVU17C
2017-04-01$370.76$331.10RVU17B
2017-01-01$370.76$331.10RVU17A
2016-10-01$366.83$327.13RVU16D
2016-07-01$366.83$327.13RVU16C
2016-04-01$366.83$327.13RVU16B
2016-01-01$366.83$327.13RVU16A
2015-10-01$368.56$328.72RVU15D
2015-07-01$368.56$328.72RVU15C
2015-04-01$366.73$327.09RVU15B
2015-01-01$366.73$327.09RVU15A
2014-10-01$368.04$329.31RVU14D
2014-07-01$368.04$329.31RVU14C
2014-04-01$368.04$329.31RVU14B
2014-01-01$368.04$329.31RVU14A
2013-10-01$377.39$336.53RVU13D
2013-07-01$377.39$336.53RVU13C
2013-04-01$377.39$336.53RVU13B
2013-01-01$377.39$336.53RVU13AR

Price 27808 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 27808 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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 King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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