CPT 27786: Ankle fracture careMedicare rate & RVUs
Report this service for nonoperative treatment of a distal fibular fracture at the lateral malleolus when the provider does not manipulate the fracture.
Medicare pays $350.04 for 27786 nationally in the office and $293.59 in a hospital or facility. Local office rates run $308.33–$455.82.
Medicare rate · 27786
Ankle fracture care
Swap in your local Medicare rate.
- Work RVUs
- 2.94
- Total RVUs
- 10.48
- Global days
- 090
National rate · 2026
$350.04
Office setting, before claim adjustments.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 27786 covers
This code covers closed, nonoperative care of a fracture at the distal fibula, or lateral malleolus, when the provider treats it without manipulating the fracture. Orthopedic surgeons and other clinicians who provide fracture care may use it for a stable lateral malleolus fracture managed with immobilization, such as a cast or brace. The fracture pattern and the treatment actually performed distinguish this service from reduction or operative repair.
Choose the code based on the documented fracture site and whether manipulation or surgery was performed. The record should identify the distal fibular fracture and support treatment without manipulation. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. If this code is performed with other procedures 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%. Assistant-at-surgery payment is 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.
Where 27786 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$308.33 to $455.82
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $312.99 | $263.60 |
| Alaska* | $406.24 | $346.12 |
| Arizona | $340.20 | $285.50 |
| Arkansas | $308.33 | $259.84 |
| Atlanta | $357.70 | $300.35 |
| Austin | $361.74 | $302.02 |
| Bakersfield | $367.30 | $305.43 |
| Baltimore/Surr. Cntys | $372.96 | $312.39 |
| Beaumont | $327.72 | $276.35 |
| Brazoria | $344.75 | $288.82 |
| Chicago | $375.26 | $318.53 |
| Chico | $365.79 | $303.92 |
| Colorado | $362.23 | $302.17 |
| Connecticut | $373.80 | $313.00 |
| Dallas | $347.43 | $291.21 |
| Dc + Md/Va Suburbs | $399.00 | $332.50 |
| Delaware | $345.91 | $290.13 |
| Detroit | $354.23 | $299.76 |
| East St. Louis | $349.63 | $297.69 |
| El Centro | $365.88 | $304.01 |
| Fort Lauderdale | $367.65 | $310.47 |
| Fort Worth | $345.33 | $289.67 |
| Fresno | $365.79 | $303.92 |
| Galveston | $346.09 | $290.04 |
| Hanford-Corcoran | $365.79 | $303.92 |
| Hawaii, Guam | $374.48 | $310.30 |
| Houston | $355.97 | $299.92 |
| Idaho | $321.83 | $269.90 |
| Indiana | $323.70 | $271.38 |
| Iowa | $319.29 | $267.64 |
| Kansas | $318.65 | $267.62 |
| Kentucky | $322.56 | $272.37 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $390.79 | $324.02 |
| Madera | $365.79 | $303.92 |
| Manhattan | $404.77 | $339.18 |
| Merced | $365.79 | $303.92 |
| Metropolitan Boston | $397.44 | $330.04 |
| Metropolitan Kansas City | $335.36 | $282.36 |
| Metropolitan Philadelphia | $364.88 | $306.11 |
| Metropolitan St. Louis | $338.85 | $285.12 |
| Miami | $387.21 | $328.44 |
| Minnesota | $344.12 | $286.04 |
| Mississippi | $312.83 | $264.23 |
| Modesto | $365.79 | $303.92 |
| Montana** | $350.01 | $293.56 |
| Napa | $421.70 | $347.31 |
| Nebraska | $320.82 | $268.72 |
| Nevada** | $347.26 | $290.76 |
| New Hampshire | $357.37 | $298.61 |
| New Mexico | $334.26 | $282.50 |
| New Orleans | $338.70 | $285.58 |
| North Carolina | $327.87 | $275.20 |
| North Dakota** | $339.33 | $282.88 |
| Northern Nj | $394.86 | $329.38 |
| Nyc Suburbs/Long Island | $415.97 | $348.86 |
| Ohio | $329.84 | $278.31 |
| Oklahoma | $321.00 | $270.59 |
| Oxnard-Thousand Oaks-Ventura | $388.54 | $321.82 |
| Portland | $372.95 | $310.23 |
| Poughkpsie/N Nyc Suburbs | $380.46 | $318.65 |
| Puerto Rico | $352.34 | $295.27 |
| Queens | $406.85 | $340.13 |
| Redding | $365.79 | $303.92 |
| Rest Of California | $365.79 | $303.92 |
| Rest Of Florida | $348.83 | $294.86 |
| Rest Of Georgia | $328.25 | $277.90 |
| Rest Of Illinois | $339.85 | $288.32 |
| Rest Of Louisiana | $322.40 | $272.44 |
| Rest Of Maine | $324.52 | $272.59 |
| Rest Of Maryland | $352.35 | $295.23 |
| Rest Of Massachusetts | $360.34 | $300.90 |
| Rest Of Michigan | $332.03 | $280.49 |
| Rest Of Missouri | $317.31 | $268.65 |
| Rest Of New Jersey | $377.23 | $315.59 |
| Rest Of New York | $332.99 | $279.37 |
| Rest Of Oregon | $343.75 | $287.53 |
| Rest Of Pennsylvania | $329.88 | $278.06 |
| Rest Of Texas | $336.37 | $282.80 |
| Rest Of Washington | $359.40 | $299.96 |
| Rhode Island | $357.67 | $299.36 |
| Riverside-San Bernardino-Ontario | $371.60 | $309.74 |
| Sacramento-Roseville-Folsom | $383.32 | $317.67 |
| Salinas | $381.89 | $316.47 |
| San Diego-Chula Vista-Carlsbad | $390.55 | $323.04 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $445.47 | $365.88 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $444.86 | $365.27 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $455.82 | $374.42 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $453.31 | $371.91 |
| San Luis Obispo-Paso Robles | $375.84 | $311.55 |
| Santa Cruz-Watsonville | $394.00 | $325.42 |
| Santa Maria-Santa Barbara | $383.23 | $317.42 |
| Santa Rosa-Petaluma | $397.93 | $328.61 |
| Seattle (King Cnty) | $404.72 | $335.46 |
| South Carolina | $329.57 | $277.41 |
| South Dakota** | $338.07 | $281.62 |
| Southern Maine | $341.28 | $285.34 |
| Stockton | $365.79 | $303.92 |
| Suburban Chicago | $370.97 | $312.99 |
| Tennessee | $320.41 | $269.10 |
| Utah | $334.17 | $281.11 |
| Vallejo | $420.82 | $346.42 |
| Vermont | $338.79 | $282.91 |
| Virgin Islands | $352.34 | $295.27 |
| Virginia | $340.76 | $285.28 |
| Visalia | $365.79 | $303.92 |
| West Virginia | $327.19 | $278.13 |
| Wisconsin | $327.74 | $273.66 |
| Wyoming** | $345.35 | $288.90 |
| Yuba City | $365.79 | $303.92 |
27786 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.
$308.33
$410.81
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $406.24 | 1 |
| AL | $312.99 | 1 |
| AR | $308.33 | 1 |
| AZ | $340.20 | 1 |
| CA | $365.79–$455.82 | 29 |
| CO | $362.23 | 1 |
| CT | $373.80 | 1 |
| DC | $399.00 | 1 |
| DE | $345.91 | 1 |
| FL | $348.83–$387.21 | 3 |
| GA | $328.25–$357.70 | 2 |
| GU | $374.48 | 1 |
| HI | $374.48 | 1 |
| IA | $319.29 | 1 |
| ID | $321.83 | 1 |
| IL | $339.85–$375.26 | 4 |
| IN | $323.70 | 1 |
| KS | $318.65 | 1 |
| KY | $322.56 | 1 |
| LA | $322.40–$338.70 | 2 |
| MA | $360.34–$397.44 | 2 |
| MD | $352.35–$399.00 | 3 |
| ME | $324.52–$341.28 | 2 |
| MI | $332.03–$354.23 | 2 |
| MN | $344.12 | 1 |
| MO | $317.31–$338.85 | 3 |
| MS | $312.83 | 1 |
| MT | $350.01 | 1 |
| NC | $327.87 | 1 |
| ND | $339.33 | 1 |
| NE | $320.82 | 1 |
| NH | $357.37 | 1 |
| NJ | $377.23–$394.86 | 2 |
| NM | $334.26 | 1 |
| NV | $347.26 | 1 |
| NY | $332.99–$415.97 | 5 |
| OH | $329.84 | 1 |
| OK | $321.00 | 1 |
| OR | $343.75–$372.95 | 2 |
| PA | $329.88–$364.88 | 2 |
| PR | $352.34 | 1 |
| RI | $357.67 | 1 |
| SC | $329.57 | 1 |
| SD | $338.07 | 1 |
| TN | $320.41 | 1 |
| TX | $327.72–$361.74 | 8 |
| UT | $334.17 | 1 |
| VA | $340.76–$399.00 | 2 |
| VI | $352.34 | 1 |
| VT | $338.79 | 1 |
| WA | $359.40–$404.72 | 2 |
| WI | $327.74 | 1 |
| WV | $327.19 | 1 |
| WY | $345.35 | 1 |
How the 27786 rate is calculated
Each of 27786’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 · 27786
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.94Practice expense 7.00Malpractice 0.54
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27786
27786 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27786
Ankle fracture care
| 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 · 27786
Ankle fracture care
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
27786 without 50 · national office
$350.04
Ankle fracture care
27786-50 · Bilateral: 150%
$525.06
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).
27786 compared with similar codes
Compare codes
27786 vs 27788 vs 27792 vs 27808: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27788Ankle fracture care
- Both codes address closed treatment of a distal fibular fracture. Choose 27786 when treatment is without manipulation and 27788 when manipulation is performed.
- 27792Ankle fracture surgery
- 27792 describes open treatment of the distal fibular fracture. Use 27786 for closed treatment without manipulation.
- 27808Ankle fracture care
- 27808 is for closed treatment without manipulation of a bimalleolar ankle fracture. Use 27786 when the treated fracture is at the distal fibula and the documented pattern is not bimalleolar.
27786 billing questions
How is this code different from 27788?
Both describe closed treatment of a distal fibular fracture at the lateral malleolus. Use 27786 when the provider does not manipulate the fracture; 27788 describes treatment with manipulation.
When is 27792 more appropriate?
Use 27792 when the distal fibular fracture is treated operatively through an open approach. This code describes closed treatment without manipulation.
Can modifier 50 be reported for bilateral fractures?
Yes. CMS lists this as a bilateral procedure; modifier 50 is paid at 150% when the service is performed bilaterally.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What documentation supports choosing this code?
Document the distal fibular or lateral malleolar fracture and that it was treated closed without manipulation. If the treatment involves manipulation or open repair, choose the corresponding code instead.
Can an assistant or co-surgeon be paid for this service?
CMS lists a statutory restriction on assistant-at-surgery payment. Co-surgeons and team surgery are not permitted for this code.
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
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