$444.99
Both codes address closed treatment of a distal fibular fracture. Choose 27786 when treatment is without manipulation and 27788 when manipulation is performed.
On this page
CMS RVU26D · Effective 2026-10-01
27786 Ankle fracture care Medicare reimbursement rates in Alabama
Report this service for nonoperative treatment of a distal fibular fracture at the lateral malleolus when the provider does not manipulate the fracture. Compare 27786 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27786 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$312.99
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$263.60
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Fracture treatment
About 27786: Closed lateral malleolus fracture treatment
Report this service for nonoperative treatment of a distal fibular fracture at the lateral malleolus when the provider does not manipulate the fracture.
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.
CMS billing rules for 27786
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.94 · 28%
- Practice expense (office) RVU7.00 · 67%
- Malpractice RVU0.54 · 5%
14.3K
Medicare services in 2024 · #1284 by national volume
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.
27786 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
27792 describes open treatment of the distal fibular fracture. Use 27786 for closed treatment without manipulation.
$340.97
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.
Compare 27786 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$312.99
Facility
$263.60
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27786 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
3,050
- Code
- 27786
- Physician work
- 2.94
- Practice expense
- 7.00
- Malpractice
- 0.54
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.94 | × 1.000 | 2.9400 |
| Practice expense | 7.00 | × 0.875 | 6.1250 |
| Malpractice | 0.54 | × 0.566 | 0.3056 |
| Total RVUs | 9.3706 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$312.99
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.94 | 1 |
| Practice expense | 7 | 0.875 |
| Malpractice | 0.54 | 0.566 |
(2.94 × 1 + 7 × 0.875 + 0.54 × 0.566) × $33.4009 = $312.99
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.94 | 1 |
| Practice expense | 5.31 | 0.875 |
| Malpractice | 0.54 | 0.566 |
(2.94 × 1 + 5.31 × 0.875 + 0.54 × 0.566) × $33.4009 = $263.60
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,04727780,,Treatment of fibula fracture,A,,2.76,7.26,,5.60,,0.56,10.58,8.92,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04827781,,Treatment of fibula fracture,A,,4.48,9.28,,6.80,,0.93,14.69,12.21,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04927784,,Treatment of fibula fracture,A,,9.43,8.86,NA,8.86,,1.86,20.15,20.15,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05027786,,Treatment of ankle fracture,A,,2.94,7.00,,5.31,,0.54,10.48,8.79,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05127788,,Treatment of ankle fracture,A,,4.52,9.42,,6.89,,0.99,14.93,12.40,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05227792,,Treatment of ankle fracture,A,,8.53,8.06,NA,8.06,,1.61,18.20,18.20,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05327808,,Treatment of ankle fracture,A,,2.95,7.92,,6.05,,0.58,11.45,9.58,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515