$377.80
Use 27808 for closed treatment without manipulation when the fracture is bimalleolar, rather than involving all three malleoli.
On this page
CMS RVU26D · Effective 2026-10-01
27816 Ankle fracture care Medicare reimbursement rates in Delaware
Closed management of a trimalleolar ankle fracture without manipulation, reported when the physician selects nonoperative fracture care for the three-malleolus injury. Compare 27816 office and facility rates across CMS payment localities in Delaware.
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 27816 in Delaware?
Delaware 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
$377.38
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$309.73
1 of 1 localities have a supported rate.
Payment area: Delaware
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.
Orthopedic fracture care
About 27816: Closed treatment of trimalleolar ankle fracture
Closed management of a trimalleolar ankle fracture without manipulation, reported when the physician selects nonoperative fracture care for the three-malleolus injury.
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.
CMS billing rules for 27816
- 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 RVU2.99 · 26%
- Practice expense (office) RVU7.83 · 68%
- Malpractice RVU0.62 · 5%
698
Medicare services in 2024 · #3263 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.
27816 compared with similar codes
Office rates for Delaware, from the same CMS release.
$577.27
Use 27818 for a trimalleolar fracture when treatment includes manipulation and is performed without skeletal traction.
No office rate
Use 27822 when the trimalleolar fracture is treated open and the posterior lip is not fixed.
No office rate
Use 27823 for open treatment of a trimalleolar fracture that includes fixation of the posterior lip.
Compare 27816 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
Delaware →
Office / nonfacility
$377.38
Facility
$309.73
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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 27816 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
3,056
- Code
- 27816
- Physician work
- 2.99
- Practice expense
- 7.83
- Malpractice
- 0.62
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.99 | × 1.005 | 3.0050 |
| Practice expense | 7.83 | × 0.988 | 7.7360 |
| Malpractice | 0.62 | × 0.899 | 0.5574 |
| Total RVUs | 11.2984 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$377.38
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.99 | 1.005 |
| Practice expense | 7.83 | 0.988 |
| Malpractice | 0.62 | 0.899 |
(2.99 × 1.005 + 7.83 × 0.988 + 0.62 × 0.899) × $33.4009 = $377.38
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.99 | 1.005 |
| Practice expense | 5.78 | 0.988 |
| Malpractice | 0.62 | 0.899 |
(2.99 × 1.005 + 5.78 × 0.988 + 0.62 × 0.899) × $33.4009 = $309.73
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.
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% under the supplied fee schedule rule.
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 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.
3,05327808,,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
3,05427810,,Treatment of ankle fracture,A,,5.19,10.47,,7.54,,1.17,16.83,13.90,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05527814,,Treatment of ankle fracture,A,,10.35,9.00,NA,9.00,,2.04,21.39,21.39,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05627816,,Treatment of ankle fracture,A,,2.99,7.83,,5.78,,0.62,11.44,9.39,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05727818,,Treatment of ankle fracture,A,,5.55,10.71,,7.46,,1.25,17.51,14.26,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05827822,,Treatment of ankle fracture,A,,10.93,11.67,NA,11.67,,2.14,24.74,24.74,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05927823,,Treatment of ankle fracture,A,,12.83,12.28,NA,12.28,,2.53,27.64,27.64,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503