Billing code 27788: Ankle fracture careMedicare rate & RVUs

Medicare pays $498.68 for 27788 nationally in the office and $414.17 in a hospital or facility. Local office rates run $438.27–$639.01.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 27788 covers

This code represents closed treatment of a distal fibular fracture at the lateral malleolus when the clinician manipulates the fracture to improve alignment. It is typically reported by an orthopedic surgeon or other qualified treating clinician after a closed reduction, with immobilization such as a cast or splint. The fracture may be managed in an office, emergency department, or hospital setting; the code hinges on the manipulation, not the location of care.

Choose this code when documentation supports a distal fibular fracture and closed manipulation, rather than closed treatment without manipulation or open treatment. The record should identify the fracture site, reduction or manipulation performed, and treatment plan. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily 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 27788 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27788 rates by state

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

How the 27788 rate is calculated

Each of 27788’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.

Payment rules and modifiers for 27788

27788 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

27788 compared with similar codes

How to choose

27786Ankle fracture care

Both address closed treatment of the lateral malleolus. Report 27788 when the fracture is manipulated; report 27786 when it is treated without manipulation.

27792Ankle fracture surgery

27792 describes open treatment of a distal fibular fracture. This code applies when treatment and manipulation are closed.

27762Ankle fracture care

27762 is for closed treatment with manipulation of a medial malleolar fracture. This code is for the distal fibula at the lateral malleolus.

Codes related to 27788

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

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

Open CMS sourceHow we calculate rates