CPT code 27816: Ankle fracture care, trimalleolar, no manipulation2026 Medicare rate & RVUs in Maryland
Closed management of a trimalleolar ankle fracture without manipulation, reported when the physician selects nonoperative fracture care for the three-malleolus injury.
Medicare pays $384.55–$436.39 for 27816 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 27816 covers
Code 27816 describes definitive nonoperative care for a fracture involving the medial, lateral, and posterior malleoli of the ankle, when the physician does not manipulate the fracture. The care typically includes immobilization and management of the injury by an orthopedist or another physician providing fracture treatment, in an office or facility setting. It is distinct from an evaluation alone when the physician assumes responsibility for treating the fracture.
Report the code when documentation supports a trimalleolar fracture and closed treatment without manipulation. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur 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%. 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.
Where 27816 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$384.55 to $436.39
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $407.70 | $334.23 |
| Rest of Maryland | $384.55 | $315.25 |
| Washington, DC area | $436.39 | $355.73 |
How the 27816 rate is calculated
Each of 27816’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 · 27816
RVUs × geographic indexes × conversion factor
Work2.99
2.99 RVUs× 1.000 GPCI
Practice expense7.83
7.83 RVUs× 1.000 GPCI
Malpractice0.62
0.62 RVUs× 1.000 GPCI
Adjusted RVUs
11.4400
Conversion factor
$33.4009
Medicare rate
$382.11
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27816
27816 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27816
Ankle fracture care, trimalleolar, no manipulation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27816
Ankle fracture care, trimalleolar, no 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27816 without 50 · national office
$382.11
Ankle fracture care, trimalleolar, no manipulation
27816-50 · Bilateral: 150%
$573.17
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).
27816 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27808Ankle fracture careBimalleolar, without manipulation
- Use 27808 for closed treatment without manipulation when the fracture is bimalleolar, rather than involving all three malleoli.
- 27818Ankle fracture careTrimalleolar, with manipulation
- Use 27818 for a trimalleolar fracture when treatment includes manipulation and is performed without skeletal traction.
- 27822Ankle fracture surgeryWithout posterior lip fixation
- Use 27822 when the trimalleolar fracture is treated open and the posterior lip is not fixed.
- 27823Ankle fracture repairPosterior lip fixation
- Use 27823 for open treatment of a trimalleolar fracture that includes fixation of the posterior lip.
27816 billing questions
How does 27816 differ from 27818?
Both address a trimalleolar ankle fracture. Use 27816 when treatment is performed without manipulation; 27818 is for treatment with manipulation and without skeletal traction.
Does the fracture need to involve all three malleoli?
Yes. The documented injury should involve the medial, lateral, and posterior malleoli. A bimalleolar fracture belongs to a different code selection.
Can routine fracture follow-up be billed separately?
Related postoperative care during the 90-day global period is included. The code represents fracture treatment rather than a separate code for each routine follow-up visit.
How is bilateral treatment reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 27816. 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
Fee sheets · Coming soon
Put 27816 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist