CPT code 27816: Ankle fracture care, trimalleolar, no manipulation2026 Medicare rate & RVUs in Vermont

Closed management of a trimalleolar ankle fracture without manipulation, reported when the physician selects nonoperative fracture care for the three-malleolus injury.

CMS RVU26DEffective Oct 1, 2026One payment locality698 Medicare services in 2024

In Vermont, Medicare pays $369.26 for 27816 in the office and $301.47 when it’s performed in a hospital or facility.

$369.26Office (non-facility)
$301.47Hospital or facility
−3.4%vs the national office rate ($382.11)

Check a contract rate as a % of Medicare · 27816 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 27816 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 27816 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 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.

How Vermont compares for 27816

Across 109 of 109 payment localities, the office rate for 27816 runs from $335.19 in Arkansas to $499.08 in San Benito County, CA. Vermont pays $369.26. The RVUs are the same everywhere; the geographic indexes change the dollars.

27816 in Vermont vs other payment areas
  1. Vermont · this page$369.26
  2. Los Angeles, CA · California$427.10+$57.84
  3. Washington, DC area · District of Columbia$436.39+$67.13
  4. Miami, FL · Florida$424.49+$55.23
  5. Chicago, IL · Illinois$410.93+$41.67
  6. Manhattan, NY · New York$443.00+$73.74
  7. Alaska · Alaska$439.74+$70.48

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

Every other payment area

27816 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$340.43$280.51
ArkansasArkansas$335.19$276.37
ArizonaArizona$371.02$304.67
Bakersfield, CACalifornia$401.01$325.97
Chico, CACalifornia$399.30$324.26
El Centro, CACalifornia$399.41$324.36
Fresno, CACalifornia$399.30$324.26
Hanford, CACalifornia$399.30$324.26

27816 rates by state

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

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.

$335.19

$449.19

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

View every state and territory as a table
27816 office rate range by state
State / territoryOffice rate rangeLocalities
AK$439.741
AL$340.431
AR$335.191
AZ$371.021
CA$399.30–$499.0829
CO$395.511
CT$408.591
DC$436.391
DE$377.381
FL$381.02–$424.493
GA$357.84–$390.752
GU$409.221
HI$409.221
IA$347.391
ID$350.271
IL$371.01–$410.934
IN$352.371
KS$346.731
KY$351.321
LA$351.16–$369.492
MA$393.36–$434.662
MD$384.55–$436.393
ME$353.36–$372.112
MI$362.02–$387.162
MN$375.111
MO$345.48–$369.593
MS$340.351
MT$382.061
NC$357.111
ND$369.811
NE$349.091
NH$390.241
NJ$412.17–$431.652
NM$364.561
NV$378.911
NY$362.88–$455.675
OH$359.521
OK$349.501
OR$374.91–$407.432
PA$359.52–$398.622
PR$384.671
RI$390.401
SC$359.121
SD$368.361
TN$348.721
TX$357.10–$395.118
UT$364.301
VA$371.57–$436.392
VI$384.671
VT$369.261
WA$392.32–$442.682
WI$356.791
WV$356.771
WY$376.721

See 27816 in every payment locality

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

Office or facility?

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.

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,056

Code
27816
Physician work
2.99
Practice expense
7.83
Malpractice
0.62

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 27816 in Vermont
ComponentRVULocality factorAdjusted
Physician work2.99× 1.0002.9900
Practice expense7.83× 0.9907.7517
Malpractice0.62× 0.5060.3137
Total RVUs11.0554
Conversion factor× 33.4009

Office rate, Vermont$369.26

Office: (2.99 × 1 + 7.83 × 0.99 + 0.62 × 0.506) × $33.4009 = $369.26

Facility: (2.99 × 1 + 5.78 × 0.99 + 0.62 × 0.506) × $33.4009 = $301.47

Open 27816 in the RVU calculator

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

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 · 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.

  • 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

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).

When to use modifier 50

How 27816 has changed in Vermont

27816 · Office / nonfacility

$369.26

Effective 2026-10-01

The base rate is $41.49 higher than on 2025-10-01, moving from $327.77 to $369.26 (12.7%).

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

    $327.77changed to$369.26

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.07 changed to 2.99
    • Practice expense RVU 6.80 changed to 7.83
    • Malpractice RVU 0.60 changed to 0.62
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $334.49changed to$327.77

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.72 changed to 6.80
    • Malpractice RVU 0.59 changed to 0.60

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $329.03changed to$334.49

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $334.65changed to$329.03

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.51 changed to 6.72
    • Malpractice RVU 0.58 changed to 0.59
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $335.95changed to$334.65

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.29 changed to 6.51
    • Malpractice RVU 0.60 changed to 0.58
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $333.44changed to$335.95

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.15 changed to 6.29
    • Malpractice RVU 0.58 changed to 0.60

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $331.01changed to$333.44

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.73 changed to 6.15
    • Malpractice RVU 0.56 changed to 0.58
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $329.71changed to$331.01

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.69 changed to 5.73
    • Malpractice RVU 0.51 changed to 0.56
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $327.89changed to$329.71

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.65 changed to 5.69

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $323.87changed to$327.89

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.56 changed to 5.65
    • Malpractice RVU 0.53 changed to 0.51
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $321.29changed to$323.87

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.52 changed to 5.56
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $323.89changed to$321.29

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.56 changed to 5.52

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $322.28changed to$323.89

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $317.53changed to$322.28

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.44 changed to 5.56
    • Malpractice RVU 0.52 changed to 0.53
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$317.53

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$369.26$301.47RVU26D
2026-07-01$369.26$301.47RVU26C
2026-04-01$369.26$301.47RVU26B
2026-01-01$369.26$301.47RVU26A
2025-10-01$327.77$290.19RVU25D
2025-07-01$327.77$290.19RVU25C
2025-04-01$327.77$290.19RVU25B
2025-01-01$327.77$290.19RVU25A
2024-10-01$334.49$295.82RVU24D
2024-07-01$334.49$295.82RVU24C
2024-04-01$334.49$295.82RVU24B
2024-03-09$334.49$295.82RVU24AR
2024-01-01$329.03$290.99RVU24A
2023-10-01$334.65$296.13RVU23D
2023-07-01$334.65$296.13RVU23C
2023-04-01$334.65$296.13RVU23B
2023-01-01$334.65$296.13RVU23A
2022-10-01$335.95$297.49RVU22D
2022-07-01$335.95$297.49RVU22C
2022-04-01$335.95$297.49RVU22B
2022-01-01$335.95$297.49RVU22A
2021-10-01$333.44$295.37RVU21D
2021-07-01$333.44$295.37RVU21C
2021-04-01$333.44$295.37RVU21B
2021-01-01$333.44$295.37RVU21A
2020-10-01$331.01$294.63RVU20D
2020-07-01$331.01$294.63RVU20C
2020-04-01$331.01$294.63RVU20B
2020-01-01$331.01$294.63RVU20A
2019-10-01$329.71$293.50RVU19D
2019-07-01$329.71$293.50RVU19C
2019-04-01$329.71$293.50RVU19B
2019-01-01$329.71$293.50RVU19A
2018-10-01$327.89$292.08RVU18D
2018-07-01$327.89$292.08RVU18C
2018-04-01$327.89$292.08RVU18B
2018-01-01$327.89$292.08RVU18AR1
2017-10-01$323.87$290.16RVU17D
2017-07-01$323.87$290.16RVU17C
2017-04-01$323.87$290.16RVU17B
2017-01-01$323.87$290.16RVU17A
2016-10-01$321.29$287.86RVU16D
2016-07-01$321.29$287.86RVU16C
2016-04-01$321.29$287.86RVU16B
2016-01-01$321.29$287.86RVU16A
2015-10-01$323.89$289.62RVU15D
2015-07-01$323.89$289.62RVU15C
2015-04-01$322.28$288.18RVU15B
2015-01-01$322.28$288.18RVU15A
2014-10-01$317.53$284.74RVU14D
2014-07-01$317.53$284.74RVU14C
2014-04-01$317.53$284.74RVU14B
2014-01-01$317.53$284.74RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 27816 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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
RVUs for 27816PPRRVU2026_Oct_nonQPP.csv, line 3,056 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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